与大流行期间心理健康服务使用相关的因素：启动和障碍。
Factors associated with mental health service use during the pandemic: Initiation and barriers.
机构信息
Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, QC, Canada.
Centre de recherche Charles-Le Moyne, Longueuil, QC, Canada.
出版信息
Int J Soc Psychiatry. 2024 Feb;70(1):59-69. doi: 10.1177/00207640231194489. Epub 2023 Aug 30.
BACKGROUND
Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these.
AIMS
Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place.
METHODS
The sample included participants ( = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) who responded to the CanPath COVID-19 health surveys (May-December 2020 and January-June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety ( = 2,237).
RESULTS
In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care.
CONCLUSIONS
Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care.
背景
关注新的心理健康服务使用（MHSU）的启动并区分那些寻求服务但未能获得这些服务的个体的研究很少。
目的
评估与由于自我报告不需要、由于健康系统和个人障碍以及使用现有资源而没有 MHSU 而没有 MHSU 相比，与新的 MHSU 相关的因素。
方法
该样本包括对加拿大未来健康伙伴关系（CanPath）五个已建立的区域队列的参与者（ = 16435），他们对 CanPath COVID-19 健康调查（2020 年 5 月至 12 月和 2021 年 1 月至 6 月）做出了回应。进行多项回归分析以研究自大流行以来（2020 年 3 月）的 MHSU，其功能为易感性、赋权和需求因素。在总体样本和中度和重度抑郁和/或焦虑症状（MSS）（ = 2237）的个体中进行了分析。
结果
在患有 MSS 抑郁和/或焦虑的个体中，14.4%报告了新的 MHSU 的启动，22.0%由于障碍和个人原因而没有 MHSU，36.7%由于自我报告不需要而没有 MHSU。年龄、独居、较低的收入、大流行期间收入下降以及专业卫生人员身份与 MHSU 相关。与报告不舒适寻求心理健康护理或自我报告不需要的老年人相比，年轻成年人在大流行期间更有可能开始 MHSU。独居和收入较低的个体更有可能报告无法预约心理健康护理。
结论
需要开展针对老年人的宣传活动，解释寻求治疗的重要性，并提高卫生专业人员的认识，了解告知和帮助处于社会隔离和较低社会经济地位风险中的个人了解可用的心理健康资源以及促进获得护理的重要性。
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