EA4069, Paris Descartes University, Ecole des Hautes Etudes en Santé Publique, Paris, France.
Psychiatr Serv. 2011 Feb;62(2):143-51. doi: 10.1176/ps.62.2.pss6202_0143.
This study analyzed use of services from psychiatrists and other mental health professionals (psychologists, psychotherapists, counselors, and social workers) in six European countries.
Data were from respondents (N=8,796) to the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross-sectional survey (2001-2003) of a representative sample of noninstitutionalized adults in Belgium, France, Germany, Italy, the Netherlands, and Spain that was conducted via computer-assisted interviews with the Composite International Diagnostic Interview, version 3.0.
Twenty-three percent of respondents reported lifetime use of any professional for mental health problems, and 60% consulted a mental health provider. Among these, 56% used a psychiatrist and 68% used a nonpsychiatrist provider. Factors associated with use of psychiatrists only were being retired or unemployed, having 12 or fewer years of education, living in France or Spain, having a severe disorder, and using psychotropic medication. Factors associated with use of nonpsychiatrist providers only were living in the Netherlands or Germany, never being married, and having an anxiety disorder.
The findings suggest that there is no simple model of associations between mental health care system and patterns of service use. System characteristics, such as practitioner-population ratios, levels of practitioner availability, and gatekeeping and reimbursement policies, affect patterns of use of mental health providers. Recent British and Australian plans could be used as models for better allocation of services in some ESEMeD countries.
本研究分析了六位欧洲国家的精神科医生和其他心理健康专业人员（心理学家、心理治疗师、顾问和社会工作者）的服务使用情况。
数据来自欧洲精神障碍流行病学研究（ESEMeD）的受访者（N=8796），这是一项对比利时、法国、德国、意大利、荷兰和西班牙的非住院成年人群的代表性样本进行的横断面调查（2001-2003 年），采用计算机辅助访谈和复合国际诊断访谈，版本 3.0。
23%的受访者报告称曾因心理健康问题使用过任何专业人员，60%的受访者咨询过心理健康提供者。其中，56%的人使用过精神科医生，68%的人使用过非精神科医生。仅使用精神科医生的因素包括退休或失业、受教育年限为 12 年或以下、居住在法国或西班牙、患有严重疾病以及使用精神药物。仅使用非精神科医生提供者的因素包括居住在荷兰或德国、从未结婚以及患有焦虑症。
研究结果表明，精神卫生保健系统与服务使用模式之间没有简单的关联模式。系统特征，如执业者与人口的比例、执业者的可获得性水平以及守门人和报销政策，会影响心理健康提供者的使用模式。英国和澳大利亚的最新计划可以作为一些 ESEMeD 国家更好地分配服务的模式。
