Upward trends in the use of community mental health and social work services in the Netherlands between 1979 and 1995: are particular sociodemographic groups responsible?

Abstract

We investigate 1) trends in use of community mental health care (CMHC) and community social work (CSW) by Dutch households in 1979-1995; 2) whether such trends can be explained by long-term relative changes in service use or in sizes of particular household categories. Data was derived from the Facilities Use Surveys, cross-sectional population studies recording Dutch household characteristics and service use since 1979. A simulation technique was used to explain trends in service use. Use of CMHC and CSW virtually doubled in recent decades. Such trends are not explained by increasing relative service utilization in particular household categories, and only marginally by shifts in the relative sizes of such categories. They are attributable to growing rates of utilization throughout society. Trends in service use are explained by broad changes in help-seeking behaviour. Policymakers should act on these findings to narrow the persisting inequalities in service uptake.