Steel Zachary, McDonald Robert, Silove Derrick, Bauman Adrian, Sandford Phil, Herron Jennifer, Minas I Harry
Center for Population Mental Health Research, Psychiatry Research & Teaching Unit, Liverpool Hospital, New South Wales, and School of Public Health, University of Sydney, Australia.
Aust N Z J Psychiatry. 2006 Apr;40(4):347-54. doi: 10.1080/j.1440-1614.2006.01801.x.
To examine the pathways to mental health care followed by patients presenting for the first time to community- and hospital-based services and the degree to which individual characteristics, cultural background, illness type, severity and service-related variables influence the time and pathways taken to reach care.
One hundred and forty-six consecutive Australian-born, Asian and Arabic-speaking patients making their first lifetime contact with mental health services in two area health regions were included. Symptom severity was assessed using the Health of the Nations Outcome Scales. Illness explanatory models, social support, English-language proficiency and acculturation were also assessed.
An average of three professional consultations were made prior to first contact with public mental health services. Family physicians occupied a pivotal role in the help-seeking pathway with 53% of patients consulting a general practitioner. The median time taken to reach specialist mental health services was 6 months, with significantly shorter time for patients with psychotic disorders. Individual variables such as gender, social support, ethnicity and English fluency were not associated with delays in receiving public mental health care. Ethnicity was associated with lower utilization of allied health professionals.
The data suggest that social and cultural factors influence the range of professionals consulted by those with a mental illness but do not delay their presentation to public mental health services.
研究首次前往社区和医院心理健康服务机构就诊的患者所采取的获得心理健康护理的途径，以及个体特征、文化背景、疾病类型、严重程度和与服务相关的变量在多大程度上影响获得护理的时间和途径。
纳入了146名首次与两个地区卫生区域的心理健康服务机构接触的澳大利亚出生、说亚洲和阿拉伯语的患者。使用《国家健康结果量表》评估症状严重程度。还评估了疾病解释模型、社会支持、英语水平和文化适应情况。
在首次接触公共心理健康服务之前，平均进行了三次专业咨询。家庭医生在寻求帮助的途径中起着关键作用，53%的患者咨询了全科医生。获得专科心理健康服务的中位时间为6个月，患有精神障碍的患者时间明显较短。性别、社会支持、种族和英语流利程度等个体变量与获得公共心理健康护理的延迟无关。种族与对专职医疗人员的利用率较低有关。
数据表明，社会和文化因素影响患有精神疾病者咨询的专业人员范围，但不会延迟他们前往公共心理健康服务机构就诊。
