Self‐reported utilization of mental health services in the adult German population – evidence for unmet needs? Results of the DEGS1‐Mental Health Module (DEGS1‐MH)

Abstract

This paper provides up-to-date data on service use for mental health problems and disorders among adults aged 18-79 years in Germany derived from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH; N=4483). Data are based exclusively on self-report. Respondents were examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview DIA-X/M-CIDI to assess diagnoses according to the criteria of DSM-IV-TR. Service use, i.e. contact to mental health care services, due to mental health problems was assessed for the past 12 months and lifetime, by type of sector and type of institution. Among respondents with a 12-month diagnosis of a mental disorder, 23.5% of the women and 11.6% of the men reported any service use in the past 12 months. Service use depends on type of diagnosis, comorbidity and socio-demographic characteristics. Lowest 12-month utilization rates were found for substance use disorders (15.6%; lifetime use 37.3%), highest for psychotic disorders (40.5%; lifetime 72.1%). Further, a considerable time lap was found between disorder onset and subsequent service use among the majority of cases with anxiety and mood disorders. This paper provides self-reported epidemiological data on mental health service use in Germany, complementing administrative statistics and the predecessor mental health module of the German Health Interview and Examination Survey (GHS-MHS) from 1998. Despite considerable changes in the mental health field in Germany and the existence of a comprehensive mental health care system without major financial barriers, we find no indications of substantially higher utilization rates for mental disorders as compared to other comparable European countries. Further, no indications of major overall changes in utilization rates are apparent. To pinpoint areas with unmet needs, more detailed analyses of the data are needed taking into account type, frequency, and adequacy of service use and treatment of mental disorders. Appropriately matched comparisons with the GHS-MHS are needed to identify changes in patterns of utilization and interventions by type of disorder.

Effectiveness of a Web-Based Cognitive Behavioural Intervention for Subthreshold Depression: Pragmatic Randomised Controlled Trial

“…This makes the intervention potentially more attractive for people with sD. More inviting and less burdensome interventions are needed as the majority of individuals suffering from depressive symptoms do not seek help [59] , and participation rates in face-to-face interventions for sD are low [11] .…”

«Hilfe aus dem App-Store?»: Eine systematische Übersichtsarbeit und Evaluation von Apps zur Anwendung bei Depressionen

“…In Deutschland sind jährlich etwa 4,9 Millionen Menschen von der Erkrankung betroffen . Die nationale Versorgungslage ist nicht hinreichend: Bei der Hälfte aller behandlungsrelevanten Depressionsfälle erfolgt keine oder keine ausreichend lange Behandlung [Melchior et al, 2014;Mack et al, 2014]. Von den schweren Fällen bleiben etwa 18% und von den chronischen 31% ohne Behandlung [Melchior et al, 2014].…”

Collaborative stepped care for somatoform disorders: A pre–post-intervention study in primary care

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“…Second, although psychotherapy effectively reduces disability and improves functioning [19][20][21], only half the patients with somatoform disorders seek any help for their mental problems, and far less, about 11% of patients with current mental disorders have consulted a mental health specialist in the past 12 months [22]. Many patients are neither referred to psychotherapy by their PCPs, nor do they initiate psychotherapy themselves.…”

“…Many patients are neither referred to psychotherapy by their PCPs, nor do they initiate psychotherapy themselves. The shortage of available psychotherapists and long waiting lists add to the problem [22]. Collaborative psychosomatic consultations effectively improve functioning and reduce health care use, but are rarely implemented [23].…”