Hassett Anne, George Kuruvilla
University of Melbourne, Victoria, Australia.
Int J Geriatr Psychiatry. 2002 Jul;17(7):623-8. doi: 10.1002/gps.656.
With the ageing of Australia's ethnic communities, aged mental health services need to examine issues pertaining to accessibility and appropriateness in the context of this sociodemographic change. The aim of this review of referrals to a community aged-psychiatry service was to compare for differences between patients from non-English-speaking backgrounds (NESB) and English-speaking backgrounds (ESB).
Sociodemographic and clinical variables were retrospectively collated for a 12-month period and analysed according to NESB and ESB status. The 1996 Australian Census data were used for comparison of catchment area representation of different ethnic groups.
40.8% of patients referred to the service were from NESB, and 78.8% of these were assessed with an interpreter. Taken as broad ethnic groups, the referral of elderly European migrants was similar to their representation in the local population, while elderly migrants from Asia and other non-European backgrounds were under-represented. Sociodemographic differences were found in that the elderly from NESB were more likely to be poorly educated, have a low proficiency in English, and to have been employed in unskilled occupations. On the other hand, patterns of referral, diagnosis, past psychiatric history and outcome did not differ significantly between the two groups. Clinical variables relating to referral source, past psychiatric history, and outcome did not differ significantly across the two groups.
This 12-month review of referrals to an aged psychiatry community service found that nearly half were of elderly patients from NESB. The lower utilisation of the service by certain ethnic groups may reflect obstacles in their pathway to care. Alternatively, strong family networks, or a lower prevalence of mental illness in these elderly, may explain the findings in this report.
随着澳大利亚族裔社区的老龄化,老年心理健康服务需要在这种社会人口结构变化的背景下审视与可及性和适宜性相关的问题。本综述对转介至一个社区老年精神病学服务机构的案例进行研究,旨在比较非英语背景(NESB)患者和英语背景(ESB)患者之间的差异。
回顾性整理12个月期间的社会人口统计学和临床变量,并根据NESB和ESB状况进行分析。使用1996年澳大利亚人口普查数据比较不同族裔在服务区域的占比情况。
转介至该服务机构的患者中,40.8%来自NESB,其中78.8%的患者在评估时有口译人员在场。从宽泛的族裔群体来看,欧洲老年移民的转介比例与其在当地人口中的占比相似,而来自亚洲和其他非欧洲背景的老年移民转介比例较低。研究发现,NESB的老年人在社会人口统计学方面存在差异,他们受教育程度较低、英语水平较差且从事非技术工作。另一方面,两组在转介模式、诊断、既往精神病史和治疗结果方面没有显著差异。与转介来源、既往精神病史和治疗结果相关的临床变量在两组之间也没有显著差异。
对一个老年精神病学社区服务机构12个月的转介案例进行的综述发现,近一半是NESB的老年患者。某些族裔群体对该服务的利用率较低,这可能反映出他们在就医过程中存在障碍。或者,强大的家庭网络,或者这些老年人中精神疾病患病率较低,可能解释了本报告中的研究结果。