This is an analysis of data from the NIMH-sponsored Epidemiologic Catchment Area community-based study, investigating who reported discussing mental health or substance abuse problems with nonpsychiatric physicians. Data were from 7,092 respondents in four sites, all of whom had received care only in the nonpsychiatric sector in the previous six months. A multiple logistic model found that those individuals who had psychiatric disorders, and female, middle-aged, and Hispanic respondents, were more likely to have discussed emotional or mental health problems with their physicians. Respondents with alcohol abuse and substance abuse disorders did not report any more discussion of mental health problems than did respondents without alcohol or substance abuse disorders. Only 36% of the respondents who said they had discussed mental health problems were found to have psychiatric disorders by the Diagnostic Interview Survey (DIS), but many of those without disorders reported more anxiety symptoms. An analysis was done to predict which respondents with DIS-defined psychiatric disorders did not report discussing mental health problems with their nonpsychiatric physicians. Those less than 35 years of age, those older than 65 years of age, males, and those with only one recent visit to a provider were statistically at high risk for not discussing their psychiatric problems.
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Received from the Primary Care Research Program, National Institute of Mental Health, Rockville, Maryland.
The Epidemiologic Catchment Area Program is a series of five epidemiologic research studies performed by independent research teams in collaboration with staff of the Division of Clinical Research (DCR) of the National Institute of Mental Health (NIMH). The NIMH principal collaborators are Darrel A. Regier, MD, MPH, Ben Z. Locke, MSPH, and Jack D. Burke, Jr., MD, MPH; the NIMH Project Officer is William J. Huber. The Principal Investigators and Co-Investigators from the five sites are: Yale University (supported by cooperative agreement U01 MH 34224) — Jerome K. Myers, PhD, Myrna M. Weissman, PhD, and Gary Tischler, MD; Johns Hopkins University (supported by cooperative agreement U01 MH 33870) — Morton Kramer. ScD. Sam Shapiro, and Shepard Kellam, MD; Washington University (supported by cooperative agreement U01 MH 33883) — Lee N. Robins, PhD, and John Helzer, MD; Duke University (supported by cooperative agreement U01 MH 35386) — Linda George, PhD, and Dan Blazer, MD, PhD; University of California, Los Angeles (supported by cooperative agreement U01 MH 35865) — Marvin Karno, MD, Richard Hough, PhD, Javier Escobar, MD, Audrey Burnam, PhD, and Diane Timbers, PhD.
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Ford, D.E., Kamerow, D.B. & Thompson, J.W. Who talks to physicians about mental health and substance abuse problems?. J Gen Intern Med 3, 363–369 (1988). https://doi.org/10.1007/BF02595795
- primary care
- mental health services
- mental disorders
- patient participation