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1.
Ananda B. Amstadter Lisa Richardson Alicia Meyer Genelle Sawyer Dean G. Kilpatrick Trinh Luong Tran Lam Tu Trung Nguyen Thanh Tam Tran Tuan La Thi Buoi Tran Thu Ha Tran Duc Thach Mario Gaboury Ron Acierno 《Social psychiatry and psychiatric epidemiology》2011,46(2):95-100
Purpose
The purpose of the present study was to estimate the prevalence of probable mental health problems in an epidemiologic study of Vietnamese adolescents. A secondary aim was to examine the correlates of probable mental health caseness.Methods
Interviewers visited 1,914 households that were randomly selected to participate in a multi-agency study of mental health in select provinces of Vietnam. Semi-structured interviews assessed adolescent mental health problems using the Strengths and Difficulties Questionnaire (SDQ) parent informant version, and additionally the interviewers collected information on demographic variables (age, gender, ethnic group, religious affiliation, social capital). The final sample included data on 1,368 adolescents (aged 11?C18?years).Results
The average score on the total problem composite of the SDQ scale was 6.66 (SD?=?4.89), and 9.1% of the sample was considered a case (n?=?124). Bivariate analyses were conducted to determine which demographic variables were related to the SDQ case/non-case score. All variables except gender were significant in bivariate analyses, and therefore were entered into a logistic regression. Results indicated that age, religion, and wealth remained significant predictors of probable caseness.Conclusions
Overall, prevalence estimates of mental health problems generated by the SDQ were consistent with those reported in the US and other Western and non-Western samples. Results of the current study suggest some concordance of risk and protective factors between Western and Vietnamese youth (i.e., age and SES). 相似文献2.
Bøe T Overland S Lundervold AJ Hysing M 《Social psychiatry and psychiatric epidemiology》2012,47(10):1557-1566
Purpose
It is generally accepted that mental health problems are unequally distributed across population strata defined by socioeconomic status (SES), with more problems for those with lower SES. However, studies of this association in children and adolescents are often restricted by the use of global measures of mental health problems and aggregation of SES-indicators. We aim to further elucidate the relationship between childhood mental health problems and SES by including more detailed information about mental health and individual SES-indicators.Methods
The participants (N?=?5,781, age 11–13) were part of the Bergen Child Study (BCS). Mental health was assessed using the teacher, parent and self-report versions of the Strengths and Difficulties Questionnaire (SDQ), including an impact section, used to measure symptom dimensions and probability of psychiatric disorders. Parent reports of family economy and parental education were used as SES measures.Results
For each SES indicator we confirmed an inverse relationship across all the symptom dimensions. Poor family economy consistently predicted mental health problems, while parental education level predicted externalizing disorders stronger than internalizing disorders.Conclusion
In this Norwegian sample of children, family economy was a significant predictor of mental health problems as measured across a wide range of symptom dimensions and poor economy predicted a high probability of a psychiatric disorder. Longitudinal studies of the impact of low family income as well as other SES factors on externalizing and internalizing symptom dimensions and disorders are called for. 相似文献3.
Floor Bevaart Cathelijne L. Mieloo André Wierdsma Marianne C. H. Donker Wilma Jansen Hein Raat Frank C. Verhulst Floor V. A. van Oort 《Social psychiatry and psychiatric epidemiology》2014,49(5):733-742
Background
Empirical research on mental health care use and its determinants in young school-aged children is still scarce. In this study, we investigated the role of ethnicity, socioeconomic position (SEP) and perceived severity by both parents and teachers on mental health care use in 5- to 8-year-old children with emotional and/or behavioural problems.Methods
Data from 1,269 children with a high score (>P90) on the Strengths and Difficulties Questionnaire (SDQ) in the school year 2008–2009 were linked to psychiatric case register data over the years 2010–2011. Cox proportional hazards models were used to predict mental health care use from ethnicity, SEP and perceived severity of the child’s problems.Results
During the follow-up period, 117 children with high SDQ scores (9.2 %) had used mental health care for the first time. Ethnic minority children were less likely to receive care than Dutch children (HR Moroccan/Turkish: 0.26; 95 % CI 0.13–0.54, HR other ethnicity: 0.26; 95 % CI 0.12–0.58). No socioeconomic differences were found. After correction for previous care use, ethnicity and parental perceived severity, impact score as reported by teachers was significantly associated with mental health care use (HR 1.58; 95 % CI 1.01–2.46).Conclusions
Ethnicity is an important predictor of mental health care use in young children. Already in the youngest school-aged children, ethnic differences in the use of mental health care are present. A distinct predictor of care use in this age group is severity of emotional and behavioural problems as perceived by teachers. Therefore, teachers may be especially helpful in the process of identifying young children who need specialist mental health care. 相似文献4.
George Giannakopoulos Eirini Agapidaki Christine Dimitrakaki Despoina Oikonomidou Dimitra Petanidou Lia Tsermidou Gerasimos Kolaitis Yannis Tountas Kalliroi Papadopoulou 《Annals of general psychiatry》2014,13(1):1-6
Background
Early childhood education services create potentially optimal opportunities to identify and respond effectively to preschoolers' mental health problems. However, little is known about the knowledge, skills and competencies of early childhood educators in the area of mental health. The present study aimed to contribute to this field through conducting focus group interviews with professionals from public early childhood education centres in Greece.Methods
Thirty-four educators attended five focus group meetings, with each group consisting of five to nine participants and two discussion facilitators. A thematic analysis was conducted using line-by-line open coding. Constructed codes from the wording used by the participants in the interviews were created, and constant comparisons for developing themes as well as seeking data not conforming to each theme were used independently by two researchers. At the end of this process, no new information was being provided and there was repetition in each of the categories.Results
The analysis identified three themes in the data: risk factors for preschoolers' mental health problems, signs of preschoolers' mental health problems and practices of helping preschoolers with mental health problems. Results suggested that early childhood educators had satisfactory awareness of many preschoolers' mental health issues, although they showed a rather limited understanding in some domains. Moreover, they seemed to deliver inadequate practices in responding effectively to children's and families' mental health problems.Conclusions
Best practice training in working with preschoolers, families and mental health services seems essential for helping young children receive the best level of support through early identification and intervention services for possible mental health problems. 相似文献5.
Goodman A Heiervang E Fleitlich-Bilyk B Alyahri A Patel V Mullick MS Slobodskaya H Dos Santos DN Goodman R 《Social psychiatry and psychiatric epidemiology》2012,47(8):1321-1331
Purpose
To examine whether the widely used Strengths and Difficulties Questionnaire (SDQ) can validly be used to compare the prevalence of child mental health problems cross nationally.Methods
We used data on 29,225 5- to 16-year olds in eight population-based studies from seven countries: Bangladesh, Brazil, Britain, India, Norway, Russia and Yemen. Parents completed the SDQ in all eight studies, teachers in seven studies and youth in five studies. We used these SDQ data to calculate three different sorts of “caseness indicators” based on (1) SDQ symptoms, (2) SDQ symptoms plus impact and (3) an overall respondent judgement of ‘definite’ or ‘severe’ difficulties. Respondents also completed structured diagnostic interviews including extensive open-ended questions (the Development and Well-Being Assessment, DAWBA). Diagnostic ratings were all carried out or supervised by the DAWBA’s creator, working in conjunction with experienced local professionals.Results
As judged by the DAWBA, the prevalence of any mental disorder ranged from 2.2% in India to 17.1% in Russia. The nine SDQ caseness indicators (three indicators times three informants) explained 8–56% of the cross-national variation in disorder prevalence. This was insufficient to make meaningful prevalence estimates since populations with a similar measured prevalence of disorder on the DAWBA showed large variations across the various SDQ caseness indicators.Conclusions
The relationship between SDQ caseness indicators and disorder rates varies substantially between populations: cross-national differences in SDQ indicators do not necessarily reflect comparable differences in disorder rates. More generally, considerable caution is required when interpreting cross-cultural comparisons of mental health, particularly when these rely on brief questionnaires. 相似文献6.
Background
In his developmental model of emerging psychopathy, Lynam proposed that the "fledgling psychopath" is most likely to be located within a subgroup of children elevated in both hyperactivity/inattention/impulsivity (HIA) and conduct problems (CP). This approach has garnered some empirical support. However, the extent to which Lynam's model captures children who resemble psychopathy with regard to the core affective and interpersonal features remains unclear.Methods
In the present study, we investigated this issue within a large community sample of youth (N = 617). Four groups (non-HIA-CP, HIA-only, CP-only, and HIA-CP), defined on the basis of teacher reports of the Strengths and Difficulties Questionnaire (SDQ), were compared with respect to parent-reported psychopathic-like traits and subjective emotional reactivity in response to unpleasant, emotionally-laden pictures from the International Affective Pictures System (IAPS).Results
Results did not support Lynam's model. HIA-CP children did not appear most psychopathic-like on dimensions of callous-unemotional and narcissistic personality, nor did they report reduced emotional reactivity to the IAPS relative to the other children. Post-hoc regression analyses revealed a significant moderation such that elevated HIA weakened the association between CP and emotional underarousal.Conclusions
Implications of these findings with regard to the development of psychopathy are discussed. 相似文献7.
Background
Although child mental health problems are among the most important worldwide issues, development of culturally acceptable mental health services to serve the clinical needs of children and their families is especially lacking in regions outside Europe and North America. The Strengths and Difficulties Questionnaire (SDQ), which was developed in the United Kingdom and is now one of the most widely used measurement tools for screening child psychiatric symptoms, has been translated into Japanese, but culturally calibrated norms for Japanese schoolchildren have yet to be established. To this end, we examined the applicability of the Japanese versions of the parent and teacher SDQs by establishing norms and extending validation of its psychometric properties to a large nationwide sample, as well as to a smaller clinical sample.Methods
The Japanese versions of the SDQ were completed by parents and teachers of schoolchildren aged 7 to 15 years attending mainstream classes in primary or secondary schools in Japan. Data were analyzed to describe the population distribution and gender/age effects by informant, cut-off scores according to banding, factor structure, cross-scale correlations, and internal consistency for 24,519 parent ratings and 7,977 teacher ratings from a large nationwide sample. Inter-rater and test-retest reliabilities and convergent and divergent validities were confirmed for a smaller validation sample (total n?=?128) consisting of a clinical sample with any mental disorder and community children without any diagnoses.Results
Means, standard deviations, and banding of normative data for this Japanese child population were obtained. Gender/age effects were significant for both parent and teacher ratings. The original five-factor structure was replicated, and strong cross-scale correlations and internal reliability were shown across all SDQ subscales for this population. Inter-rater agreement was satisfactory, test-retest reliability was excellent, and convergent and divergent validities were satisfactory for the validation sample, with some differences between informants.Conclusions
This study provides evidence that the Japanese version of the SDQ is a useful instrument for parents and teachers as well as for research purposes. Our findings also emphasize the importance of establishing culturally calibrated norms and boundaries for the instrument’s use. 相似文献8.
Felice N. Jacka Catherine Rothon Stephanie Taylor Michael Berk Stephen A. Stansfeld 《Social psychiatry and psychiatric epidemiology》2013,48(8):1297-1306
Purpose
In this study, we aimed to examine the relationship between diet quality and depression in a prospective study of adolescents from varied ethnic and cultural backgrounds.Design
In this prospective cohort study, data were collected at two time points (2001 and 2003) from nearly 3,000 adolescents, aged either 11–12 years or 13–14 years, participating in RELACHS, a study of ethnically diverse and socially deprived young people from East London in the UK. Diet quality was measured from dietary questionnaires, and mental health assessed using the Strengths and Difficulties Questionnaire (SDQ) and the Short Mood and Feelings Questionnaire (SMFQ).Results
In cross-sectional analyses, we found evidence for an association between an unhealthy diet and mental health problems. Compared to those in the lowest quintile of Unhealthy diet score, those in the highest quintile were more than twice as likely to be symptomatic on the SDQ (OR 2.10, 95 %CI 1.38–3.20) after taking all identified confounders into account. There was also some evidence for a cross-sectional inverse association between a measure of healthy diet and mental health problems. A prospective relationship between the highest quintiles of both Healthy (OR 0.63, 95 %CI 0.38–1.05) and Unhealthy (OR 1.75, 95 %CI 1.00–3.06) diet scores and SDQ scores at follow-up was also evident, but was attenuated by final adjustments for confounders.Conclusion
This study is concordant with previous observational studies in describing relationships between measures of diet quality and mental health problems in adolescents. 相似文献9.
Armstrong G Kermode M Raja S Suja S Chandra P Jorm AF 《International journal of mental health systems》2011,5(1):17-11
Background
Unmet needs for mental health treatment in low income countries are pervasive. If mental health is to be effectively integrated into primary health care in low income countries like India then grass-roots workers need to acquire relevant knowledge and skills to be able to recognise, refer and support people experiencing mental disorders in their own communities. This study aims to provide a mental health training intervention to community health workers in Bangalore Rural District, Karnataka, India, and to evaluate the impact of this training on mental health literacy.Methods
A pre-test post-test study design was undertaken with assessment of mental health literacy at three time points; baseline, completion of the training, and three month follow-up. Mental health literacy was assessed using the interviewer-administered Mental Health Literacy Survey. The training intervention was a four day course based on a facilitator's manual developed specifically for community health workers in India.Results
70 community health workers from Doddaballapur, Bangalore Rural District were recuited for the study. The training course improved participants' ability to recognize a mental disorder in a vignette, and reduced participants' faith in unhelpful and potentially harmful pharmacological interventions. There was evidence of a minor reduction in stigmatizing attitudes, and it was unclear if the training resulted in a change in participants' faith in recovery following treatment.Conclusion
The findings from this study indicate that the training course demonstrated potential to be an effective way to improve some aspects of mental health literacy, and highlights strategies for strengthening the training course. 相似文献10.
Background
Social support programs are a critical component of care for psychiatric patients living in community or residential settings. There is little information, however, on how to optimally deliver these services in the Japanese context.Methods
We selected ten community life support centers for patients with major mental illness and administered questionnaires to 199 pairs of patients and staff members. These questionnaires consisted of twenty-six items from six categories: difficulties with interpersonal relationships; risks to physical well-being; risks to mental health; difficulties with life skills; challenges regarding living conditions; risks towards community safety. For each of these items, patients were asked whether they had experienced difficulties during the previous month, and staff members were asked the extent to which their patients needed support.Results
The results demonstrated that staff members tended to understate patients' needs regarding chronic medical conditions (p < 0.01), dietary habits (< 0.01), and excessive smoking or alcohol drinking (< 0.05). On the other hand, staff members recognized patients' needs regarding mental health problems to a greater extent than patients themselves (< 0.05).Conclusion
Results of this study suggest that social services geared towards specific tasks of daily living form an important component of comprehensive care for psychiatric patients living in community settings in Japan. 相似文献11.
Background
This study addresses limitations of prior research that have used group comparison designs to test the effects of parental illness on youth.Purpose
This study examined differences in adjustment between children of a parent with illness and peers from ‘healthy’ families controlling for the effects of whether a parent or non-parent family member is ill, illness type, demographics and caregiving.Methods
Based on questionnaire data, groups were derived from a community sample of 2,474 youth (‘healthy’ family, n?=?1768; parental illness, n?=?336; other family member illness, n?=?254; both parental and other family illness, n?=?116).Results
The presence of any family member with an illness is associated with greater risk of mental health difficulties for youth relative to peers from healthy families. This risk is elevated if the ill family member is a parent and has mental illness or substance misuse.Conclusions
Serious health problems within a household adversely impact youth adjustment. 相似文献12.
V. Buffel S. Van de Velde P. Bracke 《Social psychiatry and psychiatric epidemiology》2014,49(10):1641-1653
Purpose
This comparative study examines cross-national variation in gender differences in primary and specialized mental health care use in Europe. We investigate to what extent socioeconomic, family-related, and mental health factors explain the gender difference, and how the impact of these groups of determinants on gender differences in mental health care use varies between countries.Methods
Data from the Eurobarometer 248 (2005–2006) for 29 European countries is used and country-specific logistic regression analyses are performed.Results
Gender differences in professional care seeking are largely need based. In almost one-third of the countries examined, the gender difference is mainly attributable to women’s poorer mental health status. However, in some countries, family and socioeconomic characteristics also have an independent contribution to the gender difference in mental health care use. Women’s higher likelihood of a lower socioeconomic position, might partly explain their higher primary care use, while in some countries, it restricts their specialized care use. In addition, some social conditions, as having children and being widowed, seem to function in a few countries as suppressors of women’s care use.Conclusions
Our study has shown that the gender difference in mental health care use, with women having a higher care use, is not a consistent European phenomenon and is dependent on the type of care provider, with greater gender inequity in the use of primary health care. The social roles adopted by men and women have in some countries on top of the mental health status a relevant influence on the greater tendency among women to contact a care provider. How the socioeconomic and family characteristics moderate the relation between gender and mental health care use is not straightforward and country dependent. 相似文献13.
Dimitra Petanidou George Giannakopoulos Chara Tzavara Christine Dimitrakaki Gerasimos Kolaitis Yannis Tountas 《Child and adolescent psychiatry and mental health》2014,8(1):1-8
Background
Adolescence has been documented as the peak age of onset for mental health perturbations, clinical disorders and unsubstantiated health complaints. The present study attempted to investigate associations between multiple, recurrent subjective health complaints (SHC) with emotional/behavioural difficulties, as measured by the Strengths and Difficulties Questionnaire scale (SDQ), among Greek adolescents.Methods
Questionnaires were administered in a large, nation-wide, random, school-based sample of Greek adolescents, aged 12–18 years. Data from 1170 participants were analyzed. Adolescents with multiple, recurrent SHC were compared in terms of their emotional/behavioural difficulties to their peers with lower levels of health complaints. SDQ scales were separately investigated for their associations with multiple, recurrent SHC, after adjustment for gender, age and socioeconomic status (ses). Further analysis included multiple logistic regression models with multiple, recurrent SHC as the dependent variable and gender, age, ses and SDQ Total difficulties score as independent factors. Potential gender and age interactions were also explored.Results
Almost half of the study participants reported multiple, recurrent SHC. Adolescents with multiple, recurrent SHC had higher scores on all SDQ scales, except from the Prosocial behavior scale, compared to their peers with lower levels of health complaints. Emotional Symptoms, Conduct Problems, Hyperactivity/Inattention and Peer Problems were associated with greater likelihood of having multiple, recurrent SHC, after adjustment for gender, age and ses. The multiple logistic regression models revealed that older adolescents and girls, as well as those with increased Total difficulties score had an increased risk for multiple, recurrent SHC reporting. No significant interaction between SDQ scales and gender or age was found.Conclusions
Our study highlights the magnitude of psychological burden among adolescents experiencing multiple, recurrent SHC. Professionals in school and clinical settings should be cautious for impaired emotional/behavioural functioning when assessing adolescents with multiple, recurrent SHC, so as early identification of at-risk individuals and timely, appropriate referrals are facilitated. 相似文献14.
Richard A. Burns Kerry Sargent-Cox Paul Mitchell Kaarin J. Anstey 《Social psychiatry and psychiatric epidemiology》2014,49(11):1849-1858
Purpose
Self-rated health is frequently used as an indicator of health and quality of life in epidemiological studies. While the association between self-rated health and negative mental health is well established, associations with indictors of positive wellbeing are less clear. Data from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project were used to compare the effects of vitality and mental health on self-rated health.Methods
Participants (n = 40,712) provided information on vitality, mental health and self-rated health, were aged 45–95 years at baseline, and were followed between 1 and 10 years (M = 5.6; SD = 2.9).Results
In comparison with mental health, multi-level modelling indicated between- and within-person change in vitality was more strongly associated with self-rated health. Bivariate dual change score modelling of the cross-lagged associations between vitality and self-rated health indicated vitality to be a stronger predictor of change in self-rated health. Self-rated health was unrelated to change in vitality.Conclusion
Vitality accounted for most of the mental health effect on self-rated health and was identified as a significant predictor of change in self-rated health over a 10-year period. Promoting wellbeing and psychological functioning may have significant protective effects on negative health outcomes throughout the adult lifespan and into late life. 相似文献15.
Background
Crisis resolution and home treatment (CRHT) is one of the more recent modes of delivering acute mental health care in the community. The objective of the study was to describe the standardizations and variations in the CRHT teams in Norway in order to gain knowledge regarding the structures and processes of CRHT teams.Methods
A longitudinal survey of five CRHT teams in Norway was carried out for a period of 18 months with two sets of questionnaires-one for CRHT team profiles for a bi-yearly survey and the other for services and practices of CRHT teams for a monthly survey.Results
The five CRHT teams were configured by a set of common basic characteristics in their operations, while at the same time were variant in several areas of the teams' structures and processes. Significant differences among the teams were evident in terms of the structural aspects such as service locality, staffing and team make-up, caseload, service hours, and travel time, and the process aspects such as the number of referrals received, referral source, admission, service duration, and discharge destination. These variations are reflected upon the perspectives regarding the nature of mental health crisis, the conflicting policies in mental health services, and the nature of home-based mental health care.Conclusions
The diversity in the way CRHT teams are established and operate needs to be examined further in order to understand the reasons for such variations and their impact on the quality of services to service users and in relation to the total mental health service system in a community. 相似文献16.
17.
Ilse J. E. Flink María H. Restrepo Diana P. Blanco Mónica M. Ortegon Carolina L. Enriquez Tinneke M. J. Beirens Hein Raat 《Social psychiatry and psychiatric epidemiology》2013,48(6):917-926
Purpose
Ongoing armed conflicts, like the one in Colombia, have forcibly displaced millions of people including many young children. This study aimed to assess the mental health of internally displaced preschoolers in Bogotá Colombia and to identify correlates of mental health in these children.Methods
Cross-sectional study conducted among 279 children attending four kindergartens in a deprived neighbourhood in Bogotá. Child mental health was assessed with the Child Behaviour Checklist (CBCL) 1.5–5 years, a parent-report. Univariate analyses and multivariate logistic regressions were performed to assess the association between displacement and child mental health and to identify correlates of mental health in displaced children.Results
Displaced children (n = 90) more often met borderline cut-off scores for the CBCL scales than non-displaced children (n = 189) (e.g. total problems 46.7 vs. 22.8 %; p < 0.001). The association between displacement and presence of CBCL total problems remained after adjustment for socio-demographic factors (Adjusted OR 3.3, 95 % CI 1.5; 6.9). Caretaker’s mental health partly explained the association. In displaced children, caretaker’s mental health (p < 0.01) and family functioning (p < 0.01) were independently associated with child mental health. Exposure to traumatic events and social support was also associated with child mental health; however, associations were not independent.Conclusion
In this deprived neighbourhood in Bogotá, preschool children registered as internally displaced presented worse mental health than non-displaced peers. Family functioning and caretaker’s mental health were strongly and independently associated with displaced children’s mental health. 相似文献18.
Purpose
The aim of this review is to identify consistent themes among the qualitative literature on stigma as experienced by patients with schizophrenia receiving community mental health care. With the treatment focus of schizophrenia nowadays shifting more and more towards community-based mental health care, professionals need to be aware of the increased vulnerability of their clients in their social environment as a result of stigma towards their disease. In-depth knowledge on stigma is critical in order to offer a dignifying community mental health care.Methods
A systematic search of the qualitative literature in Web of Science, PubMed, PsycINFO and Francis was performed to review the subjective experiences and ideas on stigma in outpatients with schizophrenia.Results
Three major themes were identified in 18 studies and need to be taken into consideration when implementing an adequate community mental health care: (i) the continuing existence of stigma inherent in the health care setting, (ii) the importance of relational aspects of stigma encounters in daily life and (iii) the significance of the behavioural aspects related to previous stigma experiences and beliefs among patients.Conclusions
Despite much effort in community treatment, patients still experience stigma and discrimination. Community mental health care professionals should not only be aware of structural problems in mental health care, but should also pay considerable attention towards the relational and behavioural aspects in their clients’ life concerning stigma. Furthermore, they have the crucial role in the community to raise awareness about stigma in order to increase their clients’ acceptance in society. 相似文献19.
John Richardson Hal Morgenstern Raquel Crider Olinda Gonzalez 《Social psychiatry and psychiatric epidemiology》2013,48(4):673-683
Purpose
To explore the possible contextual effects of state-level mental health perceptions and public spending for mental health treatment on an individual’s use of mental health services, independent of the individual’s own perceptions.Methods
Cross-sectional data from the 2007 Behavioral Risk Factor Surveillance System were used. A total of 216,514 participants from 35 states and the District of Columbia were included in the study. Logistic regression and multilevel modeling were used to estimate the effects of individual-level characteristics and three state-level factors—per capita spending on community mental health services, aggregated perceptions of the effectiveness of mental health treatment and the stigma of mental illness—on the individual’s current use of mental health services.Results
Adjusting for the individual’s perceptions and characteristics, state-level perception of treatment effectiveness was positively associated with the use of mental health services [odds ratio (OR) for 5 % increase in the percentage perceiving effectiveness = 1.08; 95 % confidence interval (CI): 1.01, 1.16]. This association was strongest for individuals who experienced 1–4 days of mental distress in the past 30 days (OR = 1.17; 95 % CI 1.06, 1.29). State-level public spending on community mental health services was also positively associated with an individual’s use of mental health services (OR for a $40 increase in spending = 1.09; 95 % CI 1.01, 1.17); however, state-level perceptions of mental-illness stigma was not.Conclusions
Our findings suggest there may be contextual effects of state-level perceptions of treatment effectiveness and state spending on community mental health services on the use of mental health services. 相似文献20.
Tonelle E. Handley Frances J. Kay-Lambkin Kerry J. Inder John R. Attia Terry J. Lewin Brian J. Kelly 《Social psychiatry and psychiatric epidemiology》2014,49(2):275-282