Social determinants of mental health service utilization in Switzerland

Abstract

Objectives: To investigate whether mental health services utilization in Switzerland is equitably distributed (i.e., predicted only by the need of a person). Methods:Data on 17789 participants of the Swiss Health Survey 2012 (≥15 years) was analysed.Logistic regression analyses were conducted to predict: having been in treatment for a psychological problem; having used psychotropic medication; having had medical treatment for depression; and having visited a psychologist or psychotherapist. Need (depression severity and risky alcohol consumption) and socio-demographic variables were used as independent variables.Results: Depression severity was the strongest predictor for using mental health services. In contrast, risky alcohol consumption was not associated with an increased likelihood of using mental health services. After adjusting for need, the following groups were less likely to use (some of) the mental health services: males, young people, participants who (almost) work full-time, single/umarried, nonSwiss people and those living in rural areas. Education and income were not significantly associated with the outcomes in the adjusted analyses.Conclusions: Some socio-demographic subgroups are less likely to use mental health services despite having the same need.

Functioning mediates help-seeking for mental problems in the general population

“…Other sociodemographic variables, specifically younger age or male gender, that were described previously as associated with less help-seeking [8,54,55] were unrelated to current help-seeking in our study. Yet, regarding age, other studies had commonly included individuals up to 65 years old and above [15]; thus, our sample constituted the 'younger age' group for which less helpseeking was reported [21].…”

A Bourdieusian approach to class‐related inequalities: the role of capitals and capital structure in the utilisation of healthcare services in later life

“…This model points to the importance of three factors: those that are predisposing (individual characteristics such as age, gender, education and personal beliefs), enabling (structural and system‐level characteristics such as income and healthcare insurance) and needs related such as self‐perceived health or the degree of illness (Bremer et al . , Dey and Jorm , Lo et al . ).…”

“…Previous research on healthcare access draws on the dominant behavioural model of health service use (Andersen 1995). This model points to the importance of three factors: those that are predisposing (individual characteristics such as age, gender, education and personal beliefs), enabling (structural and system-level characteristics such as income and healthcare insurance) and needs related such as self-perceived health or the degree of illness (Bremer et al 2018, Dey and Jorm 2017, Lo et al 2016. Numerous studies have also looked at the access dimension of the use of healthcare services through the notions of availability, accessibility and affordability of healthcare services (Ensor 2004, Harris et al 2011, Kyriopoulos et al 2014, Yamada et al 2015.…”

Stigma related to targeted school-based mental health interventions: A systematic review of qualitative evidence

“…Despite the prevalence and negative impacts of mental health problems among CYP, most go untreated (Merikangas et al, 2011). Low levels of specialist service use are reported even by CYP with severely impairing mental disorders (Dey and Jorm, 2017;Merikangas et al, 2011). This unmet need for mental health care is recognised as a global public health concern (Patel et al, 2007;Polanczyk et al, 2015).…”