Armoon Bahram, Lesage Alain, Mohammadi Rasool, Khoshnazar Zahedeh, Varnosfaderani Mehran Rostami, Hosseini Aida, Fotovvati Fatemeh, Mohammadjani Fatemeh, Khosravi Leila, Beigzadeh Mehran, Griffiths Mark D
Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
Centre de Recherche de l'Institut, Universitaire en santé mentale de Montréal, Montreal, QC, Canada.
Adm Policy Ment Health. 2025 May 2. doi: 10.1007/s10488-025-01446-x.
Unmet needs refer to the gap between the health services individuals require and what they receive. Individuals with mental health issues often face barriers preventing them from accessing the care they need. A meta-analysis was conducted to estimate the pooled prevalence of unmet needs for care and barriers to care among individuals with mental health issues. The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from December 1, 1985 to August 1, 2024. Following the screening process, 204 included studies remained for meta-analysis. Individuals with mental health issues reported significant pooled prevalence rate of unmet care needs over the past year, with the most common being related to work/occupation (43%), dental care (41%), counseling (40%), social intervention (37%), mental health (34%), physical health needs (33%), skills training (32%), social network (32%), psychological distress (31%), information (27%), intimate relationships (27%), benefits (26%), harm reduction (25%), psychotic symptoms (24%), housing (24%), money and food (21%), education (20%), sexual expression (19%), home care (16%), safety (15%), self-care (15%), telephone support (9%), and child care (8%). The pooled prevalence rates of barriers to accessing care were motivational (38%), structural (37%), financial (31%), and stigmatization (25%). The findings indicated that patients with substance use disorders experienced a significantly higher prevalence of unmet care needs and barriers to accessing care compared to those with mental health disorders and homeless individuals. The results showed that unmet care needs were highest among those in established adulthood, while harm reduction was more common among adolescents and emerging adults. Physical health and food needs were most prevalent among midlife adults. Barriers to care were most common among adolescents and emerging adults, except for structural barriers, which were most frequent among midlife adults. To address the unmet employment needs of Individuals with mental health issues, comprehensive training in essential skills is recommended. Enhancing dentists' mental health understanding and fostering collaboration among healthcare providers is crucial. Government-funded, low-barrier service models for substance use disorder patients is suggested to enhance accessibility and effectiveness, while improving health service affordability and acceptability is essential.
未满足的需求是指个人所需的医疗服务与其所获得的医疗服务之间的差距。有心理健康问题的个人往往面临阻碍他们获得所需护理的障碍。进行了一项荟萃分析，以估计有心理健康问题的个人中未满足的护理需求和护理障碍的综合患病率。在PubMed、Scopus、科学网和考科蓝图书馆数据库中检索了1985年12月1日至2024年8月1日发表的相关研究。经过筛选过程，204项纳入研究留作荟萃分析。有心理健康问题的个人报告称，在过去一年中，未满足的护理需求综合患病率显著，最常见的与工作/职业（43%）、牙科护理（41%）、咨询（40%）、社会干预（37%）、心理健康（34%）、身体健康需求（33%）、技能培训（32%）、社交网络（32%）、心理困扰（31%）、信息（27%）、亲密关系（27%）、福利（26%）、减少伤害（25%）、精神病症状（24%）、住房（24%）、金钱和食物（21%）、教育（20%）、性表达（19%）、家庭护理（16%）、安全（15%）、自我护理（15%）、电话支持（9%）和儿童护理（8%）有关。获得护理的障碍综合患病率为动机性（38%）、结构性（37%）、经济性（31%）和污名化（25%）。研究结果表明，与患有精神疾病的人和无家可归者相比，患有物质使用障碍的患者未满足的护理需求和获得护理的障碍患病率显著更高。结果显示，未满足的护理需求在成年期最为普遍，而减少伤害在青少年和刚成年的人群中更为常见。身体健康和食物需求在中年成年人中最为普遍。护理障碍在青少年和刚成年的人群中最为常见，但结构性障碍在中年成年人中最为频繁。为满足有心理健康问题的个人未满足的就业需求，建议进行基本技能的综合培训。增强牙医对心理健康的理解并促进医疗服务提供者之间的合作至关重要。建议为物质使用障碍患者提供政府资助的低门槛服务模式，以提高可及性和有效性，同时提高医疗服务的可承受性和可接受性至关重要。
