Munasinghe Sithum, Page Andrew, Sperandei Sandro, Gaur Pankaj, Ferdousi Shahana, Mannan Haider, Brakoulias Vlasios
Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
Western Sydney Primary Health Network, Level 1/85 Flushcombe Road, Blacktown, NSW 2148, Australia.
Int J Environ Res Public Health. 2022 Mar 13;19(6):3382. doi: 10.3390/ijerph19063382.
Background: This study investigated the trends in primary mental health care (PMHC) service use and hospital-treated self-harm in Western Sydney (Australia). Methods: A data linkage study and descriptive ecological study of PMHC referrals investigated the trends in referrals, treatment attendance, hospital-treated self-harm, and health care practitioners (HCPs) for the period of 2013−2018 (n = 19,437). Results: There was a substantial increase in referrals from 2016. The majority of referrals were females (60.9%), those aged <45 years (71.3%), and those presenting with anxiety or affective disorders (78.9%). Referrals of those at risk of suicide increased from 9.7% in 2013 to 17.8% in 2018. There were 264 (2.2%) cases of subsequent hospital-treated self-harm, with higher rates among those at risk of suicide and those who attended <6 sessions. The number of HCPs per referral also increased from 2013, as did waiting times for treatment initiation. Conclusion: Individuals presenting to PMHC services at risk of suicide, and who subsequently presented to a hospital setting following self-harm, were more likely to either not attend services following a referral or to attend fewer services. This trend occurred in the context of an increase in the number of clients per HCP, suggesting workforce capacity has not kept pace with demand.
本研究调查了澳大利亚悉尼西部初级心理健康护理（PMHC）服务的使用趋势以及因自残而接受住院治疗的情况。方法：一项关于PMHC转诊的数据关联研究和描述性生态研究，调查了2013 - 2018年期间（n = 19437）的转诊趋势、治疗就诊情况、因自残而接受住院治疗的情况以及医疗保健从业者（HCP）的情况。结果：自2016年起转诊量大幅增加。大多数转诊患者为女性（60.9%）、年龄小于45岁者（71.3%）以及患有焦虑或情感障碍者（78.9%）。有自杀风险者的转诊比例从2013年的9.7%增至2018年的17.8%。后续有264例（2.2%）因自残而接受住院治疗的病例，有自杀风险者以及就诊次数少于6次者的比例更高。每次转诊的HCP数量自2013年起也有所增加，治疗开始的等待时间同样如此。结论：有自杀风险且随后因自残而前往医院就诊的PMHC服务患者，更有可能在转诊后不就诊或就诊次数较少。这一趋势出现在每位HCP的患者数量增加的背景下，表明劳动力能力未能跟上需求。
