Psychiatr Serv. 2013 Jul 1;64(7):638-44. doi: 10.1176/appi.ps.001232012.
Mental disability in China has become a significant public health problem. However, few studies have examined utilization of mental health services in China among people with mental disabilities. This study explored patterns of service use and associated socioeconomic factors among Chinese adults with mental disabilities.
Data from a population-based survey representing approximately 75% of the Chinese population were analyzed. Mental disability was defined as having a mental disorder (cognitive, affective, or behavior disorder) lasting more than one year that limited daily life and social functioning. The study assessed use of any mental health specialty care and use of specific types: medical services only, rehabilitation services only, and medical and rehabilitation services. Standard weighting procedures were used. Population weighted numbers, weighted proportions, and the odd ratios (ORs) were calculated.
A total of 1,909,199 noninstitutionalized adults (weighted N=984,698,518) age 18 and older were interviewed. The weighted prevalence rate of mental disability was .81%. More than 4.2 million adults with a mental disability (52%) had never used a mental health service. Several variables were associated with greater use of mental health services: urban residence (OR=1.65), high school education or higher (OR=1.66), being married (OR=1.12), medical insurance coverage (OR=1.39), and higher annual family income (OR=1.28).
The findings indicate unmet needs for mental health services among Chinese adults with mental disabilities, as well as socioeconomic inequalities in use. Strategies are needed for enhancing community mental health service systems and reducing barriers to mental health service use in China.
精神残疾在中国已成为一个重大的公共卫生问题。然而，很少有研究调查中国精神残疾人群的精神卫生服务利用情况。本研究旨在探讨中国成年精神残疾人的服务利用模式及其相关社会经济因素。
本研究使用了一项具有全国代表性的调查数据，该调查覆盖了约 75%的中国人口。精神残疾被定义为患有持续一年以上的精神障碍（认知、情感或行为障碍），限制了日常生活和社会功能。研究评估了精神残疾人使用任何精神卫生专科医疗服务以及使用特定类型服务的情况：仅医疗服务、仅康复服务以及医疗和康复服务。采用标准加权程序进行分析。计算了人口加权数、加权比例和比值比（OR）。
共有 1909199 名非住院成年人（加权 N=984698518 人，年龄在 18 岁及以上）接受了访谈。精神残疾的加权患病率为 0.81%。超过 420 万精神残疾人（52%）从未使用过精神卫生服务。一些变量与更多地使用精神卫生服务有关：城市居住（OR=1.65）、高中及以上教育（OR=1.66）、已婚（OR=1.12）、医疗保险覆盖（OR=1.39）和较高的家庭年收入（OR=1.28）。
研究结果表明，中国成年精神残疾人的精神卫生服务需求未得到满足，且服务利用存在社会经济不平等。需要制定策略来加强社区精神卫生服务系统，并减少中国精神卫生服务利用的障碍。
