Abstract
BackgroundPersons with severe mental disorders (PSMD) form a highly heterogeneous group. Identifying subgroups sharing similar PSMD profiles may help to develop treatment plans and appropriate services for their needs. This study seeks to establish a PSMD typology by looking at individual characteristics and the amount and adequacy of help received.MethodsThe study recruited a sample of 352 persons located in south-western Montreal (Quebec, Canada). Cluster analysis was used to create a PSMD typology.ResultsAnalysis yielded five clusters: 1. highly functional older women with mood disorders, receiving little help from services; 2. middle-aged men with diverse mental disorders and alcohol abuse, receiving insufficient and inadequate help; 3. middle-aged women with serious needs, mood and personality disorders and suicidal tendencies, living in autonomous apartments, and receiving ample but inadequate help; 4. highly educated younger men with schizophrenia, living in autonomous apartments, and receiving adequate help; and 5. older poorly educated men with schizophrenia, living in supervised apartments, with ample help perceived as adequate. Marked differences were found between men and women, between users diagnosed with schizophrenia and others, and between persons living in supervised or autonomous apartments.ConclusionOur study highlights the existence of parallel subgroups among PSMD related to their socio-demographic status, clinical needs and service-use profiles, which could be used to focus more appropriate interventions. For mental health service planning, it demonstrates the relevance of focusing on individuals showing critical needs who are affected by multiple mental disorders (especially when associated with alcohol abuse), and often find help received as less adequate.
Highlights
Persons with severe mental disorders (PSMD) form a highly heterogeneous group
With a view to improving service planning, this study aims to create a PSMD typology based on clinical, socio-demographic, and needs characteristics, and amount and adequacy of help received from relatives and services
Clusters with a majority of women received the most help from relatives, independently of severity of needs, and presented a lower incidence of alcohol abuse according to the Alcohol Use Disorders Identification Test (AUDIT) score, compared to clusters made up mostly of men – which is consistent with findings from the literature [7,33,34]
Summary
Persons with severe mental disorders (PSMD) form a highly heterogeneous group. Identifying subgroups sharing similar PSMD profiles may help to develop treatment plans and appropriate services for their needs. Persons with severe mental disorders (PSMD) are heavy users of health services [1] who form a highly heterogeneous group, varying widely in terms of clinical and socio-demographic characteristics, needs, and service utilization [2]. Income, urban or rural living conditions, access to health services, and co-morbidity are others factors reported in Identifying, describing and validating various subgroups sharing similar clinical and socio-demographic characteristics may help to develop treatment plans and appropriate services for their needs [3,6,7]. From a sample of 2,447 PSMD, Herman & Mowbray [1] have identified six clusters labeled “Poorest Functioning/ High Health Needs,” “Psychotic,” “Suicidal/Aggressive,” “Mentally Ill Substance Abuser,” “Demoralized” and “Best Functioning.” Based on a set of 467 individuals hospitalized with a dual diagnosis of severe mental and substance abuse disorders, Luke et al [9] found seven clusters labeled “Best Functioning,” “Unhealthy Alcohol
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