International comparisons of disparities in access to care for people with mental health conditions

Corscadden, Lisa; Callander, Emily; Topp, Stephanie M.

doi:10.1002/hpm.2553

Cited by 7 publications

(10 citation statements)

References 28 publications

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“…These qualitative studies explored access to various maternal and child healthcare services [ 17 , 19 , 22 – 24 , 28 , 31 ] or access to health services of different groups of people such as refugees [ 17 , 23 , 26 , 32 ], elderly [ 21 ], differently-abled people [ 25 ], LGBTQ [ 27 ], and migrant minorities [ 30 , 33 ]. On the other hand, there were eight quantitative descriptive studies [ 13 , 34 – 40 ]. These quantitative studies attempted to measure access to school health services [ 35 ], mental healthcare services [ 36 , 37 , 39 , 40 ], and primary healthcare services [ 13 , 34 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…On the other hand, there were eight quantitative descriptive studies [ 13 , 34 – 40 ]. These quantitative studies attempted to measure access to school health services [ 35 ], mental healthcare services [ 36 , 37 , 39 , 40 ], and primary healthcare services [ 13 , 34 , 38 ]. The remaining eight were mixed-method studies [ 41 – 48 ] which included two studies that looked into access to primary healthcare [ 42 , 43 ]; one study on maternal healthcare [ 44 ]; three studies on access to healthcare of vulnerable and indigenous populations [ 41 , 45 , 46 ]; and two which attempted to develop measures for the specific dimensions of access such as affordability, availability, and accommodation [ 47 , 48 ].…”

Section: Resultsmentioning

confidence: 99%

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Assessing healthcare access using the Levesque’s conceptual framework– a scoping review

Meister

Lefebvre

et al. 2021

Int J Equity Health

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Introduction Countries are working hard to improve access to healthcare through Universal Healthcare Coverage. To genuinely address the problems of healthcare access, we need to recognize all the dimensions and complexities of healthcare access. Levesque’s Conceptual Framework of Access to Health introduced in 2013 provides an interesting and comprehensive perspective through the five dimensions of access and the five abilities of the population to access healthcare. The objectives of this paper are to identify and analyze all empirical studies that applied Levesque’s conceptual framework for access to healthcare and to explore the experiences and challenges of researchers who used this framework in developing tools for assessing access. Methods A scoping review was conducted by searching through four databases, for studies citing Levesque et al. 2013 to select all empirical studies focusing on healthcare access that applied the framework. An initial 1838 documents underwent title screening, followed by abstract screening, and finally full text screening by two independent reviewers. Authors of studies identified from the scoping review were also interviewed. Results There were 31 studies identified on healthcare access using the Levesque framework either a priori, to develop assessment tool/s (11 studies), or a posteriori, to organize and analyze collected data (20 studies). From the tools used, 147 unique questions on healthcare access were collected, 91 of these explored dimensions of access while 56 were about abilities to access. Those that were designed from the patient’s perspective were 73%, while 20% were for health providers, and 7% were addressed to both. Interviews from seven out of the 26 authors, showed that while there were some challenges such as instances of categorization difficulty and unequal representation of dimensions and abilities, the overall experience was positive. Conclusion Levesque’s framework has been successfully used in research that explored, assessed, and measured access in various healthcare services and settings. The framework allowed researchers to comprehensively assess the complex and dynamic process of access both in the health systems and the population contexts. There is still potential room for improvement of the framework, particularly the incorporation of time-related elements of access.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Assessing healthcare access using the Levesque’s conceptual framework– a scoping review

Meister

Lefebvre

et al. 2021

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…Affordability‐related barriers were based on responses of “yes” to the questions: “during the past 12 months, was there a time when you i) had a medical problem but did not consult a doctor, ii) ‘skipped a test, treatment or follow up,’ or iii) ‘skipped medication or doses,’ ‘because of cost’?” As medication is an important part of care for mental conditions, a related barrier to access was considered if respondents answered “no” when asked if “in the past 12 months, has a doctor, nurse, or pharmacist reviewed with you all the medications you take.” Finally, we sought to consider a measure reflecting a potential lack of trust in the system. From previous analysis of potential barriers to accessing care, negative views of the health system were found to be more common people with mental health condition than people without a condition . Respondents were asked “which of the following statements comes closest to expressing your overall view of the healthcare system in your country?” We considered responses suggesting the system “has so much wrong with it that we need to completely rebuild it’ as a proxy for respondents’ potential lack of trust in the system, and a possible perceived barrier as to the approachability of care.…”

Section: Methodsmentioning

confidence: 99%

“…From previous analysis of potential barriers to accessing care, negative views of the health system were found to be more common people with mental health condition than people without a condition. 27,28 Respondents were asked "which of the following statements comes closest to expressing your overall view of the healthcare system in your country?" We considered responses suggesting the system "has so much wrong with it that we need to completely rebuild it' as a proxy for respondents' potential lack of trust in the system, and a possible perceived barrier as to the approachability of care.…”

Section: Unmet Needs For Mental Health Services and Associations Wimentioning

confidence: 99%

Who experiences unmet need for mental health services and what other barriers to accessing health care do they face? Findings from Australia and Canada

Corscadden

Callander

Topp

2019

Health Planning & Management

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Summary Purpose To examine factors associated with unmet need for mental health services and links with barriers to access to care more broadly. Methodology The Commonwealth Fund International Health Policy Surveys from 2013 and 2016 were used to explore factors associated with unmet need for adults who experienced emotional distress for 1320 respondents in Australia and 2284 in Canada. Findings Over one in five adults in Australia (21%) and in Canada (25%) experienced emotional distress, just over half said they received professional help (51% in Australia, 59% in Canada). The majority of those who did not get help indicated did not want to see a professional (37% in Australia, 30% in Canada). For those who did seek help, the factors associated with not receiving care included lower income, higher out‐of‐pocket health care costs, and poorer health. When compared with people with met needs, those with unmet needs for mental health services were more likely to also experience affordability, medication, and trust‐related access barriers (AOR range 2.41 to 7.49 for the two countries, P < 0.01). Conclusion Including unmet needs for mental health services as part of regular reporting on access to care may bring attention to access barriers for people with mental health conditions.

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“…The spectrum of mental disorders cannot simply be addressed with pharmacology and psychotherapy, but requires collaboration across services to effectively address its devastating effects on both individuals and communities . This said, people suffering from mental conditions face substantial barriers in negotiating health system compared with people without these conditions . Despite increased global efforts to achieve the ideal of comprehensive mental health care by integrating social and health services, success has been mixed .…”

Section: Introductionmentioning

confidence: 99%

At the coalface of collaborative mental health care: A qualitative study of governance and power in district‐level service provision in South Africa

Rensburg

Khan

Wouters

et al. 2018

Health Planning & Management

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Globally, there is an urgency to address fragmented mental health systems, especially in low-to-middle income countries. State and non-state mental health service collaboration is a central strategy to strengthen care. The study was undertaken to analyse the power in governance processes of public mental health service provision. Semi-structured interviews were conducted with state and non-state actors in mental health care in a South African district. Transcriptions were thematically analysed using the Framework for Assessing Power in Collaborative Processes. Findings suggested that collaborative processes were significantly state-owned, in terms of funding models, administrative and legislative jurisdiction, and state hierarchical referral structure. No formal agreements were in place, elevating the importance of key network actors to bring less-endowed NGOs into the service network. Fragmentation between the Departments of Health and Social Development was telling in district forums. Resistance to power structures unfolded, some participants sidestepping traditional hierarchies to leverage funding and support. The paper highlights the complexities and different facets of power in integrated mental health care in a South African district, adding to growing literature on the social mechanisms that influence collaboration.

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International comparisons of disparities in access to care for people with mental health conditions

Abstract: There is an imperative to improve monitoring of access to overall health care for people with MHCs and an opportunity learn from countries with fewer barriers and disparities in access to care.

Cited by 7 publications

References 28 publications

Assessing healthcare access using the Levesque’s conceptual framework– a scoping review

Assessing healthcare access using the Levesque’s conceptual framework– a scoping review

Who experiences unmet need for mental health services and what other barriers to accessing health care do they face? Findings from Australia and Canada

At the coalface of collaborative mental health care: A qualitative study of governance and power in district‐level service provision in South Africa

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