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Use of general practitioners versus mental health professionals in six European countries: the decisive role of the organization of mental health-care systems

Abstract

Objective  

To investigate patterns of use of general practitioners (GPs) and/or mental health professionals (MHPs) for mental health
reasons, across six European countries, and the extent to which these patterns of use are associated with differences in mental
health-care delivering systems.

Methods  

Data are based on the European Study of the Epidemiology of Mental Disorders (ESEMeD): a cross-sectional survey of a representative
sample of 8,796 non-institutionalized adults from six European countries, conducted between 2001 and 2003 using computer-assisted
interviews with the CIDI-3.0. Countries were classified into: MHP− for countries where access to medical professionals tends
to predominate (Belgium, France, Italy), and MHP+ where access to non-medical MHPs predominates (Germany, Spain, The Netherlands).

Results  

Among respondents consulting GPs and/or MHPs in the past year (n = 1,019), respondents from the MHP− group more often consulted GPs (68 vs. 55 % in MHP+ group), GPs and psychiatrists (23
vs. 14 %). People from the MHP+ group more often used MHPs only (45 vs. 32 %), GPs and non-medical MHPs (16 vs. 8 %). GPs
from the MHP+ group were more inclined to refer patients to MHPs. Factors associated with use of GPs versus MHPs were: being
over 49 years, not highly educated, lower income and suffering from mood or severe mental disorders.

Conclusions  

Differences in the use of GPs versus MHPs are markedly linked to individual as well as organizational factors. Interventions
are needed, in countries fostering medical access, to reimburse sessions with non-medical MHPs and improve cooperation between
professionals to obtain better practice in access to care.

  • Content Type Journal Article
  • Category Original Paper
  • Pages 1-13
  • DOI 10.1007/s00127-012-0522-9
  • Authors
    • Anne Dezetter, EA4069 Ecole des Hautes Etudes en Santé Publique (EHESP), Hôtel Dieu, Paris Descartes University, Sorbonne Paris Cité, 1 place du parvis de Notre-Dame, 75181 Paris Cedex 04, France
    • X. Briffault, CERMES3-CESAMES, Paris Descartes University, Sorbonne Paris Cité, Paris, France
    • R. Bruffaerts, Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (campus Leuven), Leuven, Belgium
    • R. De Graaf, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
    • J. Alonso, Health Services Research Unit, Municipal Institute of Medical Research (IMIM), Barcelona, Spain
    • H. H. König, Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
    • J. M. Haro, Servies de Salut Mental, Sant Joan de Déu, Sant Boi de Loobregat, Barcelona, Spain
    • G. de Girolamo, Department of Mental Health, Azienda Unita, Sanitaria Locale di Bologna, Bologna, Italy
    • G. Vilagut, Health Services Research Unit, Municipal Institute of Medical Research (IMIM), Barcelona, Spain
    • V. Kovess-Masféty, EA4069 Ecole des Hautes Etudes en Santé Publique (EHESP), Hôtel Dieu, Paris Descartes University, Sorbonne Paris Cité, 1 place du parvis de Notre-Dame, 75181 Paris Cedex 04, France
    • Journal Social Psychiatry and Psychiatric Epidemiology
    • Online ISSN 1433-9285
    • Print ISSN 0933-7954
Posted in: Journal Article Abstracts on 06/26/2012 | Link to this post on IFP |
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