Abstract
This study assesses the contribution of predisposing, enabling, and needs factors and related variables that predicted the number of healthcare professionals consulted for mental health reasons among 746 individuals with mental disorders and high psychological distress. The data were drawn from the third (T3) and fourth data collection periods (T4) of a longitudinal study conducted in a Quebec/Canada epidemiological catchment area. Hierarchical linear regression was performed on the number of types of healthcare professionals consulted in the 12 months prior to T4. Predictors were identified at T3, classified as predisposing, enabling, and needs factors (i.e., clinical and related variables) according to the Andersen Behavioral Model. Three needs factors were associated with the number of types of healthcare professionals consulted: Post-traumatic stress disorder, stressful events, and marginally suicide ideation. Three enabling factors: Having a family physician, previous use of mental health services, and employment status were also related to the dependent variable. Poor self-perception of mental health status was the only predisposing factor retained. While needs factors were the main predictors of the number of types of healthcare professionals consulted, enabling factors may reduce the influence of needs factors, by the deployment of various strategies that facilitate continuous and appropriate care.
Highlights
Mental disorders (MD) represent a challenge to the healthcare system due to their high prevalence, costs, and burden of disability, while negatively impacting quality of life for affected individuals and families [1,2]
This study was innovative in assessing predictors of diversity in the number of types of healthcare professional consultations for mental health (MH) reasons among individuals, those diagnosed with MD, but mainly those affected by high psychological distress, using the Andersen Behavioral Model
Findings revealed that needs factors were most strongly associated with the number of types of healthcare professionals consulted, but that enabling factors may reduce the influence of certain needs factors, those involving clinical variables
Summary
Mental disorders (MD) represent a challenge to the healthcare system due to their high prevalence, costs, and burden of disability, while negatively impacting quality of life for affected individuals and families [1,2]. Recurring MD and physical comorbidity are common [3,4], leading many individuals to seek extensive and diversified care [5]. Of individuals affected by MD who use services consult professionals in primary care settings for prevalent mental health (MH) conditions such as anxiety, mood, and substance use disorders [6,7], while approximately 36% of individuals with MD seek care from general practitioners and MH specialists [5]. General practitioners at the entry point to primary care are largely responsible for care co-ordination and patterns of service use.
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