Disability and Psychiatric Symptoms in Men Referred for Treatment with Work-Related Problems to Primary Mental Health Care

Abstract

The relationship between male sex and employment as barriers to accessing mental health care is unclear. The aim of this research was to examine (1) whether the clinical features of men referred to a shared mental health care (SMHC) service through primary care differed when symptoms were affecting them in the work domain; and (2) empirically re-evaluate the effectiveness of a SMHC model for work-related disability using a pre-post chart review of N = 3960 referrals to SMHC. ANOVA and logistic regression were performed to examine symptoms (Patient Health Questionnaire, PHQ) and disability (World Health Organization Disability Assessment Schedule, WHODAS 2) at entry and discharge. Men were RR (relative risk) = 1.8 (95% C.I.: 1.60–2.05) times more likely to be referred to SMHC with work problems than women. Having greater disability and more severe somatic symptoms increased the likelihood of a work-related referral. There were no significant differences after treatment. Problems in the work domain may play an important role in men’s treatment seeking and clinicians’ recognition of a mental health care need. This study is relevant because men are underrepresented in mental health (MH) treatment and primary care is the main gateway to accessing MH care. Asking men about functioning in the work domain may increase access to helpful psychiatric services.

The World Health Organization Disability Assessment Schedule 2 (WHODAS 2.0): remarks on the need to revise the WHODAS

“…Several papers with clinical approach can also be found. Reports of researches on evaluating mental functions in individuals with Huntington disease 39 ; on assessing disability in men referred for treatment with work-related primary mental health care problems 40 ; on researching the effect of a community-based rehabilitation intervention for people with schizophrenia 41 ; on investigating disability in patients undergoing neurosurgical procedures 42 ; on the knee posture during gait and global functioning post-stroke 43 ; could be examples.…”

Patient-Level Factors Associated With Referral Rates to Mental Health Services in a Network of Student-Run Free Clinics: A Pooled Cross-Sectional Study

“…34,35 Notable reasons for differences in help-seeking behaviors observed among men compared to women include lower mental health literacy, 34,36 more perceived negative stigma associated with pursuing mental health services, 35,37 and potential differences in perceived root causes of depression. 38,39 Conveying mental health symptomatology could be viewed as a constructive step in seeking help. On the other hand, the mentioned reasons that contribute to lower help-seeking behavior may influence acceptance of a referral by the diagnosing provider.…”

“…40,41 However, few free clinics offer social work services despite the amount of unmet social needs expressed among patients. 42,43 Given that employment concerns may contribute to mental health issues among men more so than women, 38 one strategy that SRFC leaders could take is integrating social work services into their care delivery, similar to other SRFCs, or partner with local organizations to connect interested patients with relevant resources (e.g., employment centers, job training). 44,45 Further research is needed on effective care delivery models that seamlessly integrate social work services in under-resourced care settings, such as SRFCs.…”