Toussaint Ebony, Roby Dylan, Yue Dahai, Franzini Luisa, Sehgal Neil
University of South Carolina, Columbia, SC, USA.
University of California, Irvine, CA, USA.
J Behav Health Serv Res. 2022 Oct;49(4):500-512. doi: 10.1007/s11414-022-09797-1. Epub 2022 May 9.
The objective of this study is to assess the predictive value of self-reported need and psychological distress in mental healthcare service use across racial and ethnic groups in California. Using 2014-2018 data for adults aged 18-64 in the California Health Interview Survey, both logistic and Poisson regression models are used to estimate mental healthcare utilization. Patient-reported outcome measures, such as psychological distress, are commonly used to evaluate healthcare utilization patterns. The Kessler-6 screener for psychological distress is frequently used as a tool for determining whether someone's level of distress necessitates evaluation by a mental healthcare professional. Serious psychological distress has been widely studied as a predictor of higher healthcare expenditures and use; however, moderate distress and self-reported need has been less examined in the literature. Seventy-two percent of individuals with moderate psychological distress felt like they needed to see a professional for their mental or emotional needs compared to 4% of individuals with serious psychological distress. Individuals with moderate psychological distress had 34% of all healthcare visits for mental or emotional needs during the study period, compared to 17% for those with serious psychological distress. Subjective unmet need for mental healthcare was reported by 77% of those who utilized mental healthcare during the study period. Studying subjective unmet need, in addition to moderate and serious distress, provides additional understanding of the need for mental healthcare and mental healthcare utilization.
本研究的目的是评估自我报告的需求和心理困扰对加利福尼亚州不同种族和族裔群体使用心理保健服务的预测价值。利用加利福尼亚健康访谈调查中2014 - 2018年18 - 64岁成年人的数据，采用逻辑回归模型和泊松回归模型来估计心理保健服务的利用率。患者报告的结局指标，如心理困扰，通常用于评估医疗保健利用模式。凯斯勒6项心理困扰筛查量表经常被用作一种工具，以确定某人的困扰程度是否需要由心理保健专业人员进行评估。严重心理困扰作为较高医疗保健支出和使用的预测因素已得到广泛研究；然而，中度困扰和自我报告的需求在文献中较少受到关注。与4%有严重心理困扰的个体相比，72%有中度心理困扰的个体感觉他们需要就其心理或情感需求寻求专业帮助。在研究期间，有中度心理困扰的个体因心理或情感需求进行的医疗就诊占所有就诊的34%，而有严重心理困扰的个体这一比例为17%。在研究期间使用心理保健服务的人群中，77%报告了对心理保健服务的主观未满足需求。除了中度和严重困扰之外，研究主观未满足需求有助于进一步了解心理保健需求和心理保健服务的利用情况。
