Abstract
Mental Health has been known to vary geographically. Different rates of utilization of mental health services in local areas reflect geographic variation of mental health and complexity of health care. Variations and inequalities in how the health care system addresses risks are two critical issues for addressing population mental health. This study examines these issues by analyzing the utilization of mental health services in Toronto at the neighbourhood level. We adopted a shared component spatial modeling approach that allows simultaneous analysis of two main health service utilizations: doctor visits and hospitalizations related to mental health conditions. Our results reflect a geographic variation of both types of mental health service utilization across neighbourhoods in Toronto. We identified hot and cold spots of mental health risks that are common to both or specific to only one type of health service utilization. Based on the evidence found, we discuss intervention strategies, focusing on the hotspots and provision of health services about doctors and hospitals, to improve mental health for the neighbourhoods. Limitations of the study and further research directions are also discussed.
Highlights
The availability of and access to health services provides an indication of the responsiveness of health systems to the population needs
Anderson et al [3] describe predisposing factors to include the policy environment at the contextual level and age or sex at the individual level; enabling contextual factors include the availability and supply of health services while individual enabling factors include health insurance or having a primary care physician; needs could include the prevalence of mental health conditions within a population at the level of context and the presence of mental health symptoms experienced by an individual
Assuming that there were no biases in data collection of doctor visits (DV) and hospital admissions (HA), hotspots may reflect dissimilarities of risk surfaces due to differences in the availability of primary care services and/or differences in the disease stage targeted by the data sources
Summary
The availability of and access to health services provides an indication of the responsiveness of health systems to the population needs. Anderson et al [3] describe predisposing factors to include the policy environment at the contextual level and age or sex at the individual level; enabling contextual factors include the availability and supply of health services while individual enabling factors include health insurance or having a primary care physician; needs could include the prevalence of mental health conditions within a population at the level of context and the presence of mental health symptoms experienced by an individual. Public Health 2018, 15, 593; doi:10.3390/ijerph15040593 www.mdpi.com/journal/ijerph
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