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心理健康问题的服务利用情况:2007年全国心理健康与幸福调查结果

Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing.

作者信息

Burgess Philip M, Pirkis Jane E, Slade Tim N, Johnston Amy K, Meadows Graham N, Gunn Jane M

机构信息

School of Population Health, University of Queensland, Queensland Centre for Mental Health Research, Qld, Australia.

出版信息

Aust N Z J Psychiatry. 2009 Jul;43(7):615-23. doi: 10.1080/00048670902970858.

Abstract

OBJECTIVES

To provide an overview of 12 month rates of service use for mental health problems and mental disorders by the general Australian adult population.

METHOD

Data came from the 2007 National Survey of Mental Health and Wellbeing (2007 NSMHWB), a nationally representative household survey of 8841 individuals aged between 16 and 85 years.

RESULTS

Overall, 11.9% of the general Australian adult population made use of any services for mental health problems in a 12 month period. Approximately one-third of people (34.9%) meeting criteria for a mental disorder did so. Female subjects with mental disorders were more likely to use services than male subjects (40.7% vs 27.5%). People in the youngest age group made relatively less use of services than older adults. Those with affective disorders were most likely to make use of services (58.6%), followed by those with anxiety (37.8%) and substance use disorders (24.0%), respectively. Mental health hospitalizations were less common than consultations with community-based providers (2.6%), whereas 34.6% consulted a community-based provider--particularly general practitioners (24.7%) and psychologists (13.2%). There was a clear dose-response effect between severity of disorders and rates of community-based service use: 63.5% of those with severe mental disorders used community-based services, compared with 40.2% and 17.7% of those with moderate and mild mental disorders, respectively. There was also a relationship between comorbidity of mental disorders and service use.

CONCLUSIONS

Rates of service use for mental health problems among those with mental disorders in Australia are less than optimal. Little international guidance is available regarding appropriate levels of treatment coverage and other comparable countries face similar difficulties. Further work is required to determine what an appropriate rate of service use is, and to set targets to reach that rate. Australia has demonstrated that concerted policy efforts can improve rates of service use. These efforts should be expanded.

摘要

目的

概述澳大利亚普通成年人群针对心理健康问题及精神障碍的12个月服务使用率。

方法

数据来自2007年全国心理健康与幸福调查(2007 NSMHWB),这是一项针对8841名年龄在16至85岁之间人群的具有全国代表性的家庭调查。

结果

总体而言,在12个月期间,11.9%的澳大利亚普通成年人群使用过任何针对心理健康问题的服务。符合精神障碍标准的人群中约三分之一(34.9%)使用过此类服务。患有精神障碍的女性比男性更有可能使用服务(40.7%对27.5%)。最年轻年龄组的人群使用服务的比例相对低于老年人。患有情感障碍的人群最有可能使用服务(58.6%),其次是焦虑症患者(37.8%)和物质使用障碍患者(24.0%)。心理健康住院治疗比与社区服务提供者的咨询更为少见(2.6%),而34.6%的人咨询过社区服务提供者,尤其是全科医生(24.7%)和心理学家(13.2%)。在障碍严重程度与社区服务使用率之间存在明显的剂量反应效应:患有严重精神障碍的人群中有63.5%使用过社区服务,相比之下,患有中度和轻度精神障碍的人群中这一比例分别为40.2%和17.7%。精神障碍的共病情况与服务使用之间也存在关联。

结论

澳大利亚患有精神障碍人群针对心理健康问题的服务使用率未达最佳水平。关于适当治疗覆盖率水平几乎没有国际指导意见,其他可比国家也面临类似困难。需要进一步开展工作来确定适当的服务使用率,并设定实现该使用率的目标。澳大利亚已证明,协调一致的政策努力可提高服务使用率。应扩大这些努力。

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