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Unequal access and unmet need: neurotic disorders and the use of primary care services
Background. In this paper we use data from the National Survey of Psychiatric Morbidity to examine how many people with neurotic disorders receive professional evaluation, and how this is affected by clinical and sociodemographic differences. We hypothesized that psychiatric symptoms and attendant d...
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Published in: | Psychological medicine 2000-11, Vol.30 (6), p.1359-1367 |
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Main Authors: | , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that cite this one |
Online Access: | Get full text |
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Summary: | Background. In this paper we use data from the National Survey of Psychiatric Morbidity to
examine how many people with neurotic disorders receive professional evaluation, and how this is
affected by clinical and sociodemographic differences. We hypothesized that psychiatric symptoms
and attendant dysfunctions would both have an effect on contacting, and that key demographic
variables would not. Method. The household component of the British National Surveys of Psychiatric Morbidity was
based on a random sample of > 10000 subjects. Psychiatric symptoms and ICD-10 diagnosis were
established by lay interviewers using the CIS-R. Social dysfunction was tapped by asking about
difficulties in performing seven types of everyday activity. We examined symptom score, ADL
deficit score and demographic variables in relation to contact with primary care physicians for
psychiatric symptoms. Results. The major determinant of contacting a primary care physician was severity, mainly due to
the level of psychiatric symptoms, but with an independent contribution from social dysfunction.
There were also significant contributions from sex, marital status, age, employment status and
whether the subject had a physical condition as well. Conclusions. The major influence on whether people seek the help of their family doctors for mental
health problems is the severity of disorder. Although there are some social inequalities in access to
family doctors, these are less important. The most salient finding from our study is that even people
suffering from high levels of psychiatric symptoms very often do not have contact with professionals
who might help them. |
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ISSN: | 0033-2917 1469-8978 |
DOI: | 10.1017/S0033291799002950 |