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瑞士心理健康服务利用的社会决定因素。

Social determinants of mental health service utilization in Switzerland.

作者信息

Dey Michelle, Jorm Anthony Francis

机构信息

Population Mental Health Group, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC, 3010, Australia.

出版信息

Int J Public Health. 2017 Jan;62(1):85-93. doi: 10.1007/s00038-016-0898-5. Epub 2016 Sep 15.

Abstract

OBJECTIVES

To investigate whether mental health services utilization in Switzerland is equitably distributed (i.e., predicted only by the need of a person).

METHODS

Data on 17,789 participants of the Swiss Health Survey 2012 (≥15 years) was analysed. Logistic regression analyses were conducted to predict: having been in treatment for a psychological problem; having used psychotropic medication; having had medical treatment for depression; and having visited a psychologist or psychotherapist. Need (depression severity and risky alcohol consumption) and socio-demographic variables were used as independent variables.

RESULTS

Depression severity was the strongest predictor for using mental health services. In contrast, risky alcohol consumption was not associated with an increased likelihood of using mental health services. After adjusting for need, the following groups were less likely to use (some of) the mental health services: males, young people, participants who (almost) work full-time, single/unmarried, non-Swiss people and those living in rural areas. Education and income were not significantly associated with the outcomes in the adjusted analyses.

CONCLUSIONS

Some socio-demographic subgroups are less likely to use mental health services despite having the same need.

摘要

目的

调查瑞士心理健康服务的利用情况是否公平分配(即仅由个人需求预测)。

方法

分析了2012年瑞士健康调查中17789名参与者(≥15岁)的数据。进行逻辑回归分析以预测:曾因心理问题接受治疗;使用过精神药物;因抑郁症接受过医学治疗;以及拜访过心理学家或心理治疗师。需求(抑郁严重程度和危险饮酒)和社会人口统计学变量用作自变量。

结果

抑郁严重程度是使用心理健康服务的最强预测因素。相比之下,危险饮酒与使用心理健康服务的可能性增加无关。在调整需求后,以下群体使用(部分)心理健康服务的可能性较小:男性、年轻人、(几乎)全职工作的参与者、单身/未婚者、非瑞士人以及居住在农村地区的人。在调整分析中,教育和收入与结果无显著关联。

结论

尽管有相同需求,但一些社会人口统计学亚组使用心理健康服务的可能性较小。

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