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Racial and ethnic differences in the mental health problems and use of mental health care.

https://arctichealth.org/en/permalink/ahliterature5973
Source
Med Care. 2005 Aug;43(8):775-84
Publication Type
Article
Date
Aug-2005
Author
Katherine M Harris
Mark J Edlund
Sharon Larson
Author Affiliation
Substance Abuse and Mental Health Services Administration, Rockville, Maryland 20856, USA. kharris@samhsa.gov
Source
Med Care. 2005 Aug;43(8):775-84
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Adult
Comparative Study
Cross-Sectional Studies
Ethnic Groups - classification
Female
Health services needs and demand
Humans
Logistic Models
Male
Mental Disorders - ethnology - therapy
Mental Health Services - utilization
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.
Social Class
United States
Abstract
OBJECTIVES: We compared rates of mental health problems and use of mental health care across multiple racial and ethnic groups using secondary data from a large, nationally representative survey. METHODS: We pooled cross-sectional data from the 2001-2003 National Surveys on Drug Use and Health. Our sample included 134,875 adults classified as white, African American, American Indian/Alaskan Native, Asian, Mexican, Central and South American, Puerto Rican, other Hispanic-Latino, or those with multiple race and ethnicities. For each group, we estimate the past year probability of: (1) having 1 or more mental health symptoms in the past year, (2) having serious mental illness in the past year, (3) using mental health care, (4) using mental health care conditional on having mental health problems, (5) reporting unmet need for mental health care, and (6) reporting unmet need for mental health care conditional on having mental health problems. RESULTS: We found significantly higher rates of mental health problems and higher self-reported unmet need relative to whites among American Indian/Alaskan Natives and lower rates of mental health problems and use of mental health care among African American, Asian, Mexican, Central and South American, and other Hispanic-Latino groups. These differences generally were robust to the inclusion of clinical and socio demographic covariates. CONCLUSIONS: Overall, our study shows wide variation in mental health morbidity and use of mental health care across racial and ethnic groups in the United States. These results can help to focus efforts aimed at understanding the underlying causes of the differences we observe.
PubMed ID
16034291 View in PubMed
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The mental health of Portuguese children.

https://arctichealth.org/en/permalink/ahliterature221748
Source
Can J Psychiatry. 1993 Feb;38(1):46-50
Publication Type
Article
Date
Feb-1993
Author
D J Pepler
I. Lessa
Author Affiliation
York University, Toronto, Ontario.
Source
Can J Psychiatry. 1993 Feb;38(1):46-50
Date
Feb-1993
Language
English
Publication Type
Article
Keywords
Child
Child Behavior Disorders - epidemiology - psychology - therapy
Child Reactive Disorders - epidemiology - psychology - therapy
Cross-Sectional Studies
Emigration and Immigration
Ethnic groups - psychology - statistics & numerical data
Female
Humans
Incidence
Life Change Events
Male
Ontario - epidemiology
Portugal - ethnology
Referral and Consultation - statistics & numerical data
Socioeconomic Factors
Abstract
This study investigated the mental health of Portuguese children in Canada. Preliminary work involved a survey of professionals serving the Portuguese community and the translation and assessment of a standardized child behaviour checklist. Forty-five Portuguese children and 45 non Portuguese children referred to a children's mental health centre were compared on demographic and family indicators and their referral source. There were similar proportions of boys and girls in the two groups, similar types of services were requested, and they had similar treatment histories. The Portuguese children were older at the time of referral and were more likely to be referred by educational agencies than the non Portuguese children. Portuguese families appeared to experience different stresses than non Portuguese families. Implications of these findings for the provision of culturally sensitive interventions for Portuguese children and their families are discussed.
PubMed ID
8448721 View in PubMed
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Source
Can J Psychiatry. 1996 Mar;41(2):93-101
Publication Type
Article
Date
Mar-1996
Author
C A Mustard
S. Derksen
D. Tataryn
Author Affiliation
Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg.
Source
Can J Psychiatry. 1996 Mar;41(2):93-101
Date
Mar-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Female
Follow-Up Studies
Health Services Misuse - statistics & numerical data
Humans
Incidence
Male
Manitoba - epidemiology
Mental Disorders - epidemiology - psychology - rehabilitation
Mental Health Services - utilization
Middle Aged
Patient Admission - statistics & numerical data
Patient Care Team - utilization
Patient Readmission - statistics & numerical data
Psychotic Disorders - epidemiology - psychology - rehabilitation
Treatment Outcome
Abstract
To describe the profile of the intensive use of mental health services over a 4-year period in a population of 1.1 million people.
Data obtained from computerized hospital separation records and physician reimbursement claims were combined to form patient-based histories of mental health care utilization. Users of mental health services in a 24-month period were hierarchically classified as having a psychotic disorder (ICD-9-CM 295-299) or a nonpsychotic disorder (ICD-9-CM 300-301, 306-309, 311). Intensive use was defined as 12 or more contact months or a minimum of 2 episodes of therapy in the 24-month period. The cohort of intensive users were followed over the subsequent 24-month interval to describe the persistence of intensive use.
In the initial observation periods, intensive users constituted 27.4% of individuals in treatment for psychotic disorder and 4.4% of persons in treatment for nonpsychotic disorder. These 2 groups, which represent 7.4% of all users of mental health care, were responsible for 53% of physician services, 72.7% of contacts with psychiatrists, and 64.4% of acute psychiatric bed days in the initial period. In the follow-up period, intensive use status was replicated by 44.6% of the cohort.
The diagnostic and therapeutic characteristics of intensive users of mental health services are heterogeneous. There is substantial persistence of intensive mental health service use over time.
PubMed ID
8705969 View in PubMed
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A conceptual paradigm for understanding culture's impact on mental health: the cultural influences on mental health (CIMH) model.

https://arctichealth.org/en/permalink/ahliterature162846
Source
Clin Psychol Rev. 2008 Feb;28(2):211-27
Publication Type
Article
Date
Feb-2008
Author
Wei-Chin Hwang
Hector F Myers
Jennifer Abe-Kim
Julia Y Ting
Author Affiliation
Department of Psychology, Claremont McKenna College, 850 Columbia Avenue, Claremont, CA, 91711 United States. wei-chin.hwang@claremontmckenna.edu
Source
Clin Psychol Rev. 2008 Feb;28(2):211-27
Date
Feb-2008
Language
English
Publication Type
Article
Keywords
Cross-Cultural Comparison
Cross-Sectional Studies
Emigrants and Immigrants - psychology
Ethnic Groups - ethnology - psychology
Female
Health Services, Indigenous
Humans
Male
Mental Disorders - epidemiology - ethnology - psychology - therapy
Patient Acceptance of Health Care
Patient care team
Risk factors
Sex Factors
Social Values
Somatoform Disorders - epidemiology - ethnology - psychology - therapy
Abstract
Understanding culture's impact on mental health and its treatment is extremely important, especially in light of recent reports highlighting the realities of health disparities and unequal treatment. This article provides a conceptual paradigm for understanding how culture influences six mental health domains, including (a) the prevalence of mental illness, (b) etiology of disease, (c) phenomenology of distress, (d) diagnostic and assessment issues, (e) coping styles and help-seeking pathways, and (f) treatment and intervention issues. Systematic interrelationships between each of these domains are highlighted and relevant literature is reviewed. Although no one model can adequately capture the complex facets of culture's influence on mental health, the Cultural Influences on Mental Health (CIMH) model serves as an important framework for understanding the complexities of these interrelationships. Implications for clinical research and practice are discussed.
PubMed ID
17587473 View in PubMed
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Gender and outpatient mental health service use.

https://arctichealth.org/en/permalink/ahliterature191729
Source
Soc Sci Med. 2002 Jan;54(1):1-10
Publication Type
Article
Date
Jan-2002
Author
Anne E Rhodes
Paula N Goering
Teresa To
J Ivan Williams
Author Affiliation
Department of Psychiatry, University of Toronto, Canada. rhodesa@smh.toronto.on.ca
Source
Soc Sci Med. 2002 Jan;54(1):1-10
Date
Jan-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antisocial Personality Disorder - epidemiology - therapy
Anxiety Disorders - epidemiology - therapy
Community Mental Health Services - utilization
Cross-Sectional Studies
Family Characteristics
Female
Health Care Surveys
Humans
Logistic Models
Male
Mental Disorders - classification - epidemiology - therapy
Middle Aged
Mood Disorders - epidemiology - therapy
Multivariate Analysis
Ontario - epidemiology
Patient Acceptance of Health Care - psychology - statistics & numerical data
Sex Distribution
Substance-Related Disorders - epidemiology - therapy
Abstract
The purpose of this study is to describe gender differences in the use of outpatient mental health services and to identify potential determinants of this use. The study sample, N = 7475 respondents 18-64 years, was drawn from the Mental Health Supplement to the Ontario Health Survey. For theoretical and empirical reasons, type of mental disorder was defined as: a Mood and/or Anxiety Disorder (Mood/Anx) or a Substance Use Disorder and/or Antisocial Behaviours (Subs/Asb) within the past year. Use was defined in relation to providers seen within the past year. Descriptive and multiple logistic regression analyses were employed including type of mental disorder, social and economic factors. Female gender remained positively associated with any use despite adjustments (adjusted OR: 1.7; 95% CI: 1.2: 2.4). The magnitude of this association was consistent across the levels of the study variables and various measures of use except volume of use where there were no gender differences. Mood/Anx appeared to mediate the gender-use relationship and was strongly associated with use (adjusted OR: 8.4; 95% CI: 5.9; 11.9). Subs/Asb was also related to use (adjusted OR: 2.6; 95% CI: 1.5; 4.3) but not to the same degree as Mood/Anx. Mood/Anx explained 60% of the crude Subs/Asb-use relationship. The evidence to suggest that Subs/Asb mediated the gender-use relationship was mixed. These findings raise questions about gender differences in illness and reporting behaviours and the health care system in its preferential treatment of women and those with Mood/Anx.
PubMed ID
11820673 View in PubMed
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Living arrangements and mental health in Finland.

https://arctichealth.org/en/permalink/ahliterature169281
Source
J Epidemiol Community Health. 2006 Jun;60(6):468-75
Publication Type
Article
Date
Jun-2006
Author
Kaisla Joutsenniemi
Tuija Martelin
Pekka Martikainen
Sami Pirkola
Seppo Koskinen
Author Affiliation
National Public Health Institute (KTL), Department of Health and Functional Capacity, Mannerheimintie 166, 00300 Helsinki, Finland. kaisla.joutsenniemi@ktl.fi
Source
J Epidemiol Community Health. 2006 Jun;60(6):468-75
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Adult
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Male
Marital status
Mental Disorders - epidemiology - psychology
Middle Aged
Questionnaires
Residence Characteristics
Retrospective Studies
Stress, Psychological - epidemiology
Abstract
Non-married persons are known to have poor mental health compared with married persons. Health differences between marital status groups may largely arise from corresponding differences in interpersonal social bonds. However, official marital status mirrors the social reality of persons to a decreasing extent, and living arrangements may be a better measure of social bonds. Little is known about mental health in different living arrangement groups. This study aims to establish the extent and determinants of mental health differences by living arrangement in terms of psychological distress (GHQ) and DSM-IV psychiatric disorders (CIDI).
Data were used from the nationally representative cross sectional health 2000 survey, conducted in 2000-1 in Finland. Altogether 4685 participants (80%) aged 30-64 years were included in these analyses; comprehensive information was available on measures of mental health and living arrangements. Living arrangements were measured as follows: married, cohabiting, living with other(s) than a partner, and living alone.
Compared with the married, persons living alone and those living with other(s) than a partner were approximately twice as likely to have anxiety or depressive disorders. Cohabiters did not differ from the married. In men, psychological distress was similarly associated with living arrangements. Unemployment, lack of social support, and alcohol consumption attenuated the excess psychological distress and psychiatric morbidity of persons living alone and of those living with other(s) than a partner by about 10%-50% each.
Living arrangements are strongly associated with mental health, particularly among men. Information on living arrangements, social support, unemployment, and alcohol use may facilitate early stage recognition of poor mental health in primary health care.
Notes
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PubMed ID
16698975 View in PubMed
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Mental health service utilization among patients with severe mental disorders.

https://arctichealth.org/en/permalink/ahliterature143402
Source
Community Ment Health J. 2011 Aug;47(4):365-77
Publication Type
Article
Date
Aug-2011
Author
Marie-Josée Fleury
Guy Grenier
Jean-Marie Bamvita
Jean Caron
Author Affiliation
Department of Psychiatry, McGill University, Montreal, Canada. flemar@douglas.mcgill.ca
Source
Community Ment Health J. 2011 Aug;47(4):365-77
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adult
Attitude to Health
Community Mental Health Services - utilization
Cross-Sectional Studies
Female
Health Behavior
Health Services Accessibility
Health services needs and demand
Humans
Male
Mental Disorders - diagnosis - psychology - therapy
Models, organizational
Patient Acceptance of Health Care
Primary Health Care - organization & administration - utilization
Quebec
Severity of Illness Index
Socioeconomic Factors
Abstract
In light of healthcare reforms, the study aims to assess variables associated with mental healthcare service utilization in general and in both primary and specialized care by patients with severe mental disorders (SMD, mainly schizophrenia). The study is based on a sample of 140 patients with SMD from five regions in Quebec (Canada). Variables were organized in accordance with Andersen's conceptual model into four factors: predisposing, enabling, needs, and service utilization. Secondary analyses were also conducted comparing patients who were hospitalized or used emergency rooms (H.ER-Group) with patients who did not use such services (WH.ER-Group). Accessibility of services, continuity of care, and having a case manager appear to be core variables that enable service utilization. Compared with the WH.ER-Group, the H.ER-Group used twice as many services. The study highlights the importance of developing a gamut of coordinated services, easily accessible in local networks, including case managers, family physicians, and shared-care development.
PubMed ID
20490675 View in PubMed
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Mental health supplement to the Ontario Health Survey: methodology.

https://arctichealth.org/en/permalink/ahliterature210716
Source
Can J Psychiatry. 1996 Nov;41(9):549-58
Publication Type
Article
Date
Nov-1996
Author
M H Boyle
D R Offord
D. Campbell
G. Catlin
P. Goering
E. Lin
Y A Racine
Author Affiliation
Centre for Studies of Children at Risk, Chedoke-McMaster Hospitals, Hamilton, Ontario.
Source
Can J Psychiatry. 1996 Nov;41(9):549-58
Date
Nov-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Diagnosis, Differential
Disabled Persons
Female
Health Surveys
Humans
Male
Mental Disorders - complications - diagnosis - epidemiology
Middle Aged
Ontario
Pilot Projects
Prevalence
Psychological Tests
Questionnaires
Regional Health Planning
Research Design
Rural Population
Severity of Illness Index
Urban Population
Abstract
To describe the methodology of a province-wide, cross-sectional, epidemiologic study of psychiatric disorder among those aged 15 years and over living in household dwellings in Ontario.
Respondents for the survey were drawn from households (N = 13002) participating in a province-wide health survey. One person per household was selected, and 9953 (76.5%) participated.
Participants and nonparticipants were similar to each other. An extensive array of data, including measures of psychiatric disorder classified using a revised version of the Composite International Diagnostic Interview (CIDI), are available for all respondents.
The Ontario Health Supplement is contained in a public-use data file at the Ontario Ministry of Health and is available to investigators for study. A strong survey design, careful measurement, and acceptable levels of response provide the rationale for our inviting researchers to access and use the Ontario Health Supplement data base.
Notes
Comment In: Can J Psychiatry. 1996 Nov;41(9):541-28946075
Comment In: Can J Psychiatry. 1998 Oct;43(8):857-89806098
PubMed ID
8946077 View in PubMed
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Mental health for older adults and benzodiazpine use.

https://arctichealth.org/en/permalink/ahliterature172302
Source
J Community Health Nurs. 2005;22(4):213-29
Publication Type
Article
Date
2005
Author
Philippe Voyer
Philippe Cappeliez
Guilhéme Pérodeau
Michel Préville
Author Affiliation
Laval University, Québec, Canada. philippe.voyer@fsi.ulaval.ca
Source
J Community Health Nurs. 2005;22(4):213-29
Date
2005
Language
English
Publication Type
Article
Keywords
Aged - psychology - statistics & numerical data
Anti-Anxiety Agents - therapeutic use
Attitude to Health
Benzodiazepines - therapeutic use
Cross-Sectional Studies
Drug Monitoring - nursing
Drug Utilization
Female
Geriatric Assessment
Health Care Surveys
Health services needs and demand
Health status
Health Surveys
Humans
Longitudinal Studies
Male
Mental Disorders - diagnosis - drug therapy - epidemiology - prevention & control
Mental Health - statistics & numerical data
Nurse's Role
Prevalence
Quebec - epidemiology
Questionnaires
Self Administration - nursing - psychology - statistics & numerical data
Socioeconomic Factors
Abstract
Benzodiazepine (BZD) drug use among community-dwelling seniors is a significant health issue. Although long-term use of BZDs by seniors is a recognized problem, little is known about the mental health of the consumers. Better knowledge of their mental health would help nurses in identifying the psychological needs of this population. The goals of this longitudinal study1 (n = 138) were to describe the mental health status of long-term users of BZDs and to compare it with the mental health of seniors who have either begun or stopped consuming BZDs over a 1-year period (from Phase 1 to Phase 2). Results showed that one third of long-term users of BZDs do not present any mental health problem. Furthermore, no differences were observed between the mental health statuses of new users of BZDs, individuals who stopped using BZDs, and long-term users of BZDs. In conclusion, at least one third of long-term users of BZDs should stop using these drugs, and nurses should play a leading role in helping these seniors withdraw from BZD consumption.
PubMed ID
16245973 View in PubMed
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The relationship between mental health and drug use.

https://arctichealth.org/en/permalink/ahliterature220189
Source
Acta Psychiatr Scand. 1993 Oct;88(4):256-8
Publication Type
Article
Date
Oct-1993
Author
J. Takala
O P Ryynänen
E. Lehtovirta
H. Turakka
Author Affiliation
Department of Community Health and General Practice, University of Kuopio, Finland.
Source
Acta Psychiatr Scand. 1993 Oct;88(4):256-8
Date
Oct-1993
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Cross-Sectional Studies
Drug Prescriptions
Drug Utilization
Female
Finland
Humans
Male
Mental health
Middle Aged
Questionnaires
Abstract
The aim was to examine the relationship between mental health and use of different kinds of drugs. The study was a cross-sectional survey of a total population aged 45-69 years, conducted in 2 municipalities in southwestern Finland. Altogether 1821 people (80% of those invited), 815 men and 1006 women, took part in the screening. The subjects were examined by a questionnaire mailed beforehand and checked in a personal interview. The questionnaire contained questions about the currently used drugs and Goldberg's questionnaire on mental health. Half of the people examined used prescribed drugs currently, more women used drugs than men, and the use of drugs increased with age. Mental symptoms measured with the Goldberg Index appeared in one fifth of the subjects, showing a slight increase with age. Men with mental symptoms showed a fourfold psychotropic drug use compared with the men without mental symptoms. The women with mental symptoms showed a threefold use of psychotropic drugs compared with the women without mental symptoms. Similar differences were found also in other drug groups, for example cardiac glycosides, other cardiovascular drugs, analgesics and drugs for respiratory and digestive organs. Persons with mental disorders showed a high tendency to drug use, also when those drugs had no direct attachment to the mental problem. Men seemed more liable to somatization of mental problems than women.
PubMed ID
8256642 View in PubMed
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Social integration and mental health - a decomposition approach to mental health inequalities between the foreign-born and native-born in Sweden.

https://arctichealth.org/en/permalink/ahliterature302011
Source
Int J Equity Health. 2019 04 03; 18(1):48
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
04-03-2019
Author
Anna Brydsten
Mikael Rostila
Andrea Dunlavy
Author Affiliation
Department of Public Health Science, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-105 91, Stockholm, Sweden. anna.brydsten@su.se.
Source
Int J Equity Health. 2019 04 03; 18(1):48
Date
04-03-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Health Status Disparities
Health Surveys
Humans
Interpersonal Relations
Male
Mental Health - statistics & numerical data
Middle Aged
Socioeconomic Factors
Sweden
Transients and Migrants - psychology - statistics & numerical data
Young Adult
Abstract
The increasing mental health inequalities between native- and foreign-born persons in Sweden is an important public health issue. Improving social integration has been stressed as a key strategy to combat this development. While a vast amount of studies have confirmed the importance of social integration for good mental health, less is known about the role of different types of social integration, and how they relate to mental health inequalities. This study aimed to examine the extent to which indicators of social integration explained mental health inequalities between the native- and foreign-born.
Based on the Health on Equal Terms survey from 2011/2015 in Västra Götaland, Sweden (n =?71,643), a non-linear Oaxaca-Blinder decomposition analysis was performed comparing native- and foreign-born individuals from Nordic-, European- and non-European countries. The General Health Questionnaire was used to assess psychological distress, while 11 items assessed employment conditions and economic disparities, social relations, and experiences of discrimination to measure different aspects of social integration.
Differences in social integration explained large proportions of observed mental health differences between the native- and foreign-born. Important indicators included low levels of social activity (20%), trust in others (17%) and social support (16%), but also labour market disadvantages, such as being outside the labour market (15%), unemployment (10%) and experiencing financial strain (16%). In analyses stratified by region of origin, low trust in others and discrimination contributed to the mental health gap between the native-born and European-born (17 and 9%, respectively), and the native-born and non-European-born (19 and 10%, respectively). Precarious labour market position was a particularly important factor in the mental health gap between the native-born and Nordic-origin (22%), and non-European origin (36%) populations.
Social integration factors play a central role in explaining the mental health inequality between natives and migrants in Sweden. Our findings suggest that public health actions targeting mental health gaps could benefit from focusing on inequalities in social and economic recourses between natives and migrants in Sweden. Areas of priority include improving migrants' financial strain, as well as increasing trust in others and social support and opportunities for civic engagement.
PubMed ID
30944004 View in PubMed
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The beginnings of mental health disparities: emergent mental disorders among Indigenous adolescents.

https://arctichealth.org/en/permalink/ahliterature138556
Source
Nebr Symp Motiv. 2011;57:121-49
Publication Type
Article
Date
2011

Comparing mental health of francophones in Canada, france, and belgium: 12-month and lifetime rates of mental health service use (part 2).

https://arctichealth.org/en/permalink/ahliterature143468
Source
Can J Psychiatry. 2010 May;55(5):295-304
Publication Type
Article
Date
May-2010
Author
Raymond Tempier
Helen-Maria Vasiliadis
Fabien Gilbert
Koen Demyttenaere
Ronny Bruffaerts
Jean-Pierre Lépine
Isabelle Gasquet
Marje Lepnurm
Alain Lesage
Chassidy Puchala
Karen Mosier
Viviane Kovess-Masféty
Author Affiliation
Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan. raymond.tempier@usask.ca
Source
Can J Psychiatry. 2010 May;55(5):295-304
Date
May-2010
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - diagnosis - epidemiology - psychology
Belgium
Canada
Cross-Cultural Comparison
Cross-Sectional Studies
Depressive Disorder, Major - diagnosis - epidemiology - psychology
Female
France
Health Services Accessibility - statistics & numerical data
Health Surveys
Humans
Insurance Coverage - statistics & numerical data
Language
Male
Mental Health Services - utilization
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Referral and Consultation - statistics & numerical data
Abstract
To compare 12-month and lifetime service use for common mental disorders in 4 francophone subsamples using data from national mental health surveys in Canada, Quebec, France, and Belgium. This is the second article in a 2-part series comparing mental disorders and service use prevalence of French-speaking populations.
Comparable World Mental Health-Composite International Diagnostic Interviews (WMH-CIDI) were administered to representative samples of adults (aged 18 years and older) in Canada during 2002 and in France and Belgium from 2001 to 2003. Two groups of francophone adults in Canada, in Quebec (n = 7571) and outside Quebec (n = 500), and respondents in Belgium (n = 389) and France (n = 1436) completed the French version of the population survey. Prevalence rates of common mental health service use were examined for major depressive episodes and specific anxiety disorders (that is, agoraphobia, social phobia, and panic disorder).
Overall, most francophones with mental disorders do not seek treatment. Canadians consulted more mental health professionals than their European counterparts, with the exception of psychiatrists.
Patterns of service use are similar among francophone populations. Variations that exist may be accounted for by differences in health care resources, health care systems, and health insurance coverage.
PubMed ID
20482956 View in PubMed
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Suicidality, depression, and mental health service use in Canada.

https://arctichealth.org/en/permalink/ahliterature170595
Source
Can J Psychiatry. 2006 Jan;51(1):35-41
Publication Type
Article
Date
Jan-2006
Author
Anne E Rhodes
Jennifer Bethell
Susan J Bondy
Author Affiliation
Suicide Studies Unit, St Michael's Hospital, Toronto, Ontario. rhodesa@smh.toronto.on.ca
Source
Can J Psychiatry. 2006 Jan;51(1):35-41
Date
Jan-2006
Language
English
Publication Type
Article
Keywords
Canada
Cross-Sectional Studies
Data Collection
Depressive Disorder, Major - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Humans
Mental Health Services - utilization
Personality Assessment
Primary Health Care - statistics & numerical data
Psychiatry - statistics & numerical data
Referral and Consultation - statistics & numerical data
Risk assessment
Statistics as Topic
Suicide, Attempted - statistics & numerical data
Abstract
To determine the magnitude of depression and suicidal populations, the overlap between these populations, and the associated patterns of mental health service use.
We examined depression, suicidality (ideation and nonfatal behaviours), and the mental health service use of participants in the Canadian Community Health Survey Cycle 1.2: Mental Health and Well-Being. The sample comprised 36 984 household members aged 15 years or over.
Approximately 4% to 5% of the population suffered from a major depression or suicidality. About 2 of 3 of those who were suicidal did not suffer from depression, and over 70% of those with depression did not report suicidality. Persons with depression and suicidality or depression (but no suicidality) were the 2 groups most likely to report ambulatory mental health contacts, and the provider groups contacted most often included physicians. The use of provider groups was considerably lower for those who were suicidal (but had no depression). Whereas the latter were more likely to report contacts than not, suicidality, in and of itself, did not exert a strong effect on contact with any particular provider group. For those who were suicidal (but who had no depression), less than 1 in 3 reported any mental health service contact, including an inpatient mental health stay.
The lack of contact by those who are suicidal (but who have no depression) is provocative, given that almost 2 of 3 of the suicidal subjects had no depression. Detrimental outcomes such as depression may develop without effective early interventions and uptake by a sufficient supply of appropriately trained and financially accessible personnel.
PubMed ID
16491982 View in PubMed
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Mental health of octogenarians in Iceland. An epidemiological study.

https://arctichealth.org/en/permalink/ahliterature46704
Source
Acta Psychiatr Scand Suppl. 1989;349:1-112
Publication Type
Article
Date
1989
Author
H. Magnússon
Author Affiliation
National University Hospital in Iceland, Department of Psychiatry.
Source
Acta Psychiatr Scand Suppl. 1989;349:1-112
Date
1989
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cohort Studies
Cross-Sectional Studies
Data Collection
Dementia - epidemiology - mortality
Depressive Disorder - epidemiology - mortality
Disabled Persons
Female
Humans
Iceland
Male
Mental Disorders - diagnosis - epidemiology
Psychiatric Status Rating Scales
Research Support, Non-U.S. Gov't
Abstract
The purpose of this work was to study the prevalence and incidence of mental disorders in octogenarians in Iceland and the relation of these variables to several sociodemographic variables. Beside this a comparison between two different methods of collecting clinical data on mental health were done. In chapter 2 recent research on the epidemiology of mental disorders in the very old population is reviewed. A comparison between different studies is very difficult but most studies agree on the prevalence of severe dementia. In chapter 3 the material and methods of the study is described. The sample consists of all Icelanders borne in the years of 1895-1897. Two methods of data collection are described, the indirect method where information from general practitioners, hospital files and other sources are used to make a mental diagnosis, and the Geriatric Mental States Schedule, which is a semi-structured interview. In chapter 4 demography of the cohort is described and in chapter 5 the reliability of the Icelandic translation of the Geriatric Mental States Schedule is discussed and the reliability of the Icelandic translation of G.M.S. is within acceptable limits. In chapter 6 two methods of making mental diagnosis in the elderly are compared. In chapter 7 the prevalence of dementia at the age of 81.5 and 87 years is discussed. There is a considerable increase in prevalence of severe dementia, or from 7.8% at the age of 81.5 years to 15.1% at the age of 87 years. The incidence of dementia in the age period 74-85 years is discussed in chapter 8. At the age of 84 years the incidence is about one case per 100 per year, but at the age of 85 the incidence is about 4 cases per 100 per year. In chapter 9 the mortality of dementia in the age period from 74-85 years is discussed. The standard mortality ratio is 2.46 for males and 2.29 for females in this age period. In chapter 10 and 11 the prevalence, incidence and mortality of affective disorders are discussed. The prevalence of affective disorders does not change significantly with age from 81.5-87 years, being 8-9%, while the mortality of affective disorders in the age period of 74-85 years is similar to that in the general population. The incidence does not change significantly from 74-85 years being about 0.6 case per 100 per year for males and about 1.1 cases per 100 per year for females.(ABSTRACT TRUNCATED AT 400 WORDS)
PubMed ID
2529738 View in PubMed
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Planning mental health services: I. Background and key issues.

https://arctichealth.org/en/permalink/ahliterature224017
Source
Can J Psychiatry. 1992 Apr;37(3):199-206
Publication Type
Article
Date
Apr-1992
Author
D. Wasylenki
P. Goering
E. Macnaughton
Author Affiliation
Continuing Care Division, Clarke Institute of Psychiatry, Toronto, Ontario.
Source
Can J Psychiatry. 1992 Apr;37(3):199-206
Date
Apr-1992
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Canada - epidemiology
Community Mental Health Services - trends
Cross-Sectional Studies
Deinstitutionalization - trends
Health planning - trends
Health Services Needs and Demand - trends
Humans
Incidence
Mental Disorders - epidemiology - psychology - rehabilitation
Abstract
Planning mental health services is a complex task requiring an understanding of background developments and key issues related to mental health services. In Canada, the deinstitutionalization of patients attempted to shift the locus of care from provincial psychiatric hospitals to general hospital psychiatric units. This resulted in the isolation of provincial psychiatric hospitals, general hospital psychiatric units and community mental health programs, with little overall accountability for the services provided--three solitudes. To move toward the creation of responsible, integrated systems a number of issues must be addressed: target population(s); the roles of provincial psychiatric and general hospitals; community support services; continuity of care; co-morbidity; consumerism; and methods of integration. In the development of a comprehensive mental health plan, each issue should be recognized and decisions made which are in keeping with current knowledge. A companion report will survey Canadian initiatives in mental health planning and discuss approaches to many of the issues identified.
PubMed ID
1591672 View in PubMed
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Epidemiologic assessment of overmet need in mental health care.

https://arctichealth.org/en/permalink/ahliterature207788
Source
Soc Psychiatry Psychiatr Epidemiol. 1997 Aug;32(6):355-62
Publication Type
Article
Date
Aug-1997
Author
E. Lin
P N Goering
A. Lesage
D L Streiner
Author Affiliation
Health Systems Research Unit, Clarke Institute of Psychiatry, Toronto, Ontario, Canada.
Source
Soc Psychiatry Psychiatr Epidemiol. 1997 Aug;32(6):355-62
Date
Aug-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Analysis of Variance
Chi-Square Distribution
Cross-Sectional Studies
Female
Health Care Surveys
Health Services Misuse - statistics & numerical data
Health Services Needs and Demand - classification - statistics & numerical data
Humans
Male
Mental Disorders - epidemiology
Mental Health Services - utilization
Middle Aged
Ontario - epidemiology
Sampling Studies
Abstract
The traditional purpose of psychiatric epidemiologic surveys has been the assessment of mental illness and, by implication, the need for care. Previous research has focused on unmet need, defined as those who meet "caseness" but do not receive care, but has rarely examined the converse. Since survey respondents receiving care but not meeting caseness have been found to represent up to one-half of mental health service users, this is a significant service delivery issue. The data are drawn from the Mental Health Supplement to the Ontario Health Survey (the Supplement), a household survey of 9,953 respondents, which used the University of Michigan's version of the Composite International Diagnostic Interview (UM-CIDI) as its diagnostic instrument. Community residents who used formal mental health services in the past year but who did not have a concurrent UM-CIDI/DSM-III-R (Diagnostic and Statistical Manual 3, revised) diagnosis were defined as "treated without CIDI disorder". Their need for care was evaluated by comparing them to "treated depressed" and "healthy" respondents, using indicators of functional impairment, vulnerability to developing disorder, and risk of relapse. The match between need and care levels was examined by comparing their type and intensity of use with those of the treated depressed. Results present strong evidence for conceptualizing need as continuous, rather than discrete. The results for the group defined as "treated without CIDI disorder" were consistently between those for the other two groups (with the "treated depressed" always showing the highest need) on all indicators as well as on a summary need index. However, their type and intensity of service use appeared to be unrelated to their level of need. Although some of the "treated without CIDI disorder" group may require preventive or follow-up treatment, the need for service for others is not as convincingly demonstrated. Outcome studies are needed to provide comparative data to describe more fully the problems experienced by this group and indicate whether treatment is helpful. In an age of fiscal restraint, when resource reallocation (rather than generation of new resources) is the likely scenario, such close examination of the fit between need and care is critical if services are to be targeted appropriately.
PubMed ID
9299930 View in PubMed
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GP group profiles and involvement in mental health care.

https://arctichealth.org/en/permalink/ahliterature139005
Source
J Eval Clin Pract. 2012 Apr;18(2):396-403
Publication Type
Article
Date
Apr-2012
Author
Marie-Josée Fleury
Jean-Marie Bamvita
Lambert Farand
Denise Aubé
Louise Fournier
Alain Lesage
Author Affiliation
Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre (DMHUIRC), Montréal, Québec, Canada. flemar@douglas.mcgill.ca
Source
J Eval Clin Pract. 2012 Apr;18(2):396-403
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bayes Theorem
Cluster analysis
Cross-Sectional Studies
Disease Management
Female
Humans
Male
Mental Disorders - therapy
Mental Health Services - organization & administration
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Physician's Role
Physicians, Family
Quebec
Questionnaires
Abstract
Mental health is one of the leading causes of morbidity worldwide. Its impact in terms of cost and loss of productivity is considerable. Improving the efficiency of mental health care system has thus been a high priority for decision makers. In the context of current reforms that privilege the reinforcement of primary mental health care and integration of services, this article brings new lights on the role of general practitioners (GPs) in managing mental health, and shared-care initiatives developed to deal with more complex cases. The study presents a typology of GPs providing mental health care, by identifying clusters of GP profiles associated with the management of patients with common or serious mental disorders (CMD or SMD).
GPs in Quebec (n = 398) were surveyed on their practice, and socio-demographic data were collected.
Cluster analysis generated five GP profiles, including three that were closely tied to mental health care (labelled, respectively: group practice GPs, traditional pro-active GPs and collaborative-minded GPs), and two not very implicated in mental health (named: diversified and low-implicated GPs, and money-making GPs).
The study confirmed the central role played by GPs in the treatment of patients with CMD and their relative lack of involvement in the care of patients with SMD. Study results support current efforts to strengthen collaboration among primary care providers and mental health specialists, reinforce GP training, and favour multi-modal clinical and collaborative strategies in mental health care.
PubMed ID
21114798 View in PubMed
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Does regular attendance at sporting events promote mental health?

https://arctichealth.org/en/permalink/ahliterature200757
Source
Can J Psychiatry. 1999 Aug;44(6):608
Publication Type
Article
Date
Aug-1999

[Mental health in costal areas of Finnmark 1987-93]

https://arctichealth.org/en/permalink/ahliterature72568
Source
Tidsskr Nor Laegeforen. 1998 Mar 30;118(9):1350-5
Publication Type
Article
Date
Mar-30-1998
Author
R. Olstad
A J Søgaard
H. Sexton
Author Affiliation
Institutt for samfunnsmedisin Universitetet i Tromsø.
Source
Tidsskr Nor Laegeforen. 1998 Mar 30;118(9):1350-5
Date
Mar-30-1998
Language
Swedish
Publication Type
Article
Keywords
Adult
Aged
Cross-Sectional Studies
English Abstract
Female
Humans
Male
Mental Disorders - epidemiology
Mental health
Middle Aged
Norway - epidemiology
Questionnaires
Self Concept
Socioeconomic Factors
Abstract
Over 70% of the adult population of five rural communities in Northern Norway participated in a three-part epidemiological study that included identical questions on mental health. Data were collected in 1987/88, 1990 and 1993. Both repeated cross-sectional analyses and individual growth curve analyses on the 2,486 individuals who participated in either two or three surveys were carried out in order to reveal the changes in mental health over time. The proportion of the population using sleeping pills or psychotropic drugs decreased significantly as time progressed. There were also a significant decrease in the proportion of people who reported being depressed or dissatisfied with life, or who had insomnia or problems in coping. A similar improvement in mental health was noted for both sexes and it remained statistically significant even after adjusting for age and level of education. There was no decrease in the proportion of individuals who reported loneliness. The time effect remained significant, even after adjusting for multiple factors in the growth curve analyses. Improvement in mental health has occurred despite the crisis in the region's fishing industry.
PubMed ID
9599497 View in PubMed
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