Psychiatr Serv. 2014 Jun 1;65(6):826-9. doi: 10.1176/appi.ps.201300301.
This cross-sectional study examined factors associated with unmet need for care from primary care physicians or from psychiatrists among clients enrolled in mental health court support programs in Toronto, Ontario.
The sample included adults admitted to these programs during 2009 (N=994). Both measures of unmet need were determined by mental health court workers at program intake. Predictors included client predisposing, clinical, and enabling variables.
Twelve percent had unmet need for care from primary care physicians and 34% from psychiatrists. Both measures of unmet need were associated with having an unknown diagnosis, having no income source or receiving welfare, homelessness, and not having a case manager. Unmet need for care from psychiatrists was associated with symptoms of serious mental illness and current hospitalization.
Obtaining care from psychiatrists appears to be a particular challenge for justice-involved persons with mental illness. Policies and practices that improve access warrant more attention.
本横断面研究调查了安大略省多伦多市心理健康法庭支持计划中登记的客户中，未能从初级保健医生或精神科医生那里获得医疗服务的相关因素。
该样本包括在 2009 年期间被纳入这些计划的成年人（N=994）。心理健康法庭工作人员在计划入组时确定了两种未满足的医疗服务需求的衡量标准。预测因素包括患者的倾向因素、临床因素和促成因素。
12%的人需要初级保健医生的医疗服务，34%的人需要精神科医生的医疗服务。两种未满足的医疗服务需求都与未确诊、无收入来源或接受福利、无家可归以及没有个案管理员有关。需要精神科医生的医疗服务与严重精神疾病的症状和当前住院有关。
对于涉及司法的精神疾病患者来说，获得精神科医生的治疗似乎是一个特别的挑战。需要更多关注改善获得治疗机会的政策和实践。
