Abstract
This study investigated the utilization of Mental Health Services (MHS) and associated predisposing, enabling, and need factors among residents of Shanghai, China. It used a cross-sectional design and a structured questionnaire. We selected 3502 residents aged 18 years and older through multi-stage, stratified random sampling; trained mental health personnel interviewed them. Multivariate logistic regression analysis explored the predictors of MHS utilization. Among respondents, approximately 21.4% reported depressive symptoms, whereas only 4.7% had utilized MHS. The factors that were significantly related to MHS utilization were the predisposing factors of gender, marital status, occupation, and mental health knowledge; the enabling factors of perceived need for mental health help, regular mental health resources, and government salvage objects; and the need factors of moderate and severe depressive symptoms. Underutilization of MHS in Shanghai is pervasive and worrisome. Interventions in the culture and environment to improve public mental health knowledge are crucial.
References
Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health & Social Behavior 36(1), 1.
Bobevski, I., Rosen, A., & Meadows, G. (2017). Mental health service use and need for care of Australians without diagnoses of mental disorders: Findings from a large epidemiological survey. Epidemiology & Psychiatric Sciences, 26, 596–606.
Chappell, N. L., & Blandford, A. A. (1987). Health service utilization by elderly persons. Canadian Journal of Sociology, 12(3), 195–215.
Codony, M., Alonso, J., Almansa, J., Bernert, S., de Girolamo, G., de Graaf, R., et al. (2009). Perceived need for mental health care and service use among adults in Western Europe: Results of the ESEMeD project. Psychiatric Services, 60(8), 1051–1058.
Wang, J, Wu, Y., Zhou, B., Zhang, S., Chen, K. (2009). Factors associated with non-use of inpatient hospital care service by elderly people in China. Health & Social Care in the Community, 17(5), 476–484.
Forrest, C. B. (2003). Primary care in the United States: Primary care gatekeeping and referrals: Effective filter or failed experiment? BMJ, 326(7391), 692–695.
Hochhausen, L., Le, H. N., & Perry, D. F. (2011). Community-based mental health service utilization among low-income Latina immigrants. Community Mental Health Journal, 47(1), 14–23.
Kessler, R. C., Brown, R. L., & Broman, C. L. (1981). Sex differences in psychiatric help-seeking: Evidence from four large-scale surveys. Journal of Health & Social Behavior 22(1), 49–64.
Kronenfeld, J. J. (2005). Social factors, need, and mental health services utilization: Findings of the national comorbidity survey. Research in the Sociology of Health Care, 23, 57–78.
Liu, J., Ma, H., He, Y. L., Xie, B., Xu, Y. F., Tang, H. Y., et al. (2011). Mental health system in China: History, recent service reform and future challenges. World Psychiatry Official Journal of the World Psychiatric Association, 10(3), 210–216.
Mackenzie, C. S., Pagura, J., & Sareen, J. (2010). Correlates of perceived need for and use of mental health services by older adults in the collaborative psychiatric epidemiology surveys. American Journal of Geriatric Psychiatry Official Journal of the American Association for Geriatric Psychiatry, 18(12), 1103–1115.
Minkler, M. (2005). Community-based research partnerships: Challenges and opportunities. Journal of Urban Health, 82(2), i3–i12.
Park, S. Y., Cho, S., Park, Y., Bernstein, K. S., & Shin, J. K. (2013). Factors associated with mental health service utilization among Korean American immigrants. Community Mental Health Journal, 49(6), 765–773.
Parslow, R., Jorm, A., Christensen, H., & Jacomb, P. (2002). Factors associated with young adults’ obtaining general practitioner services. Australian Health Review A Publication of the Australian Hospital Association, 25(6), 109–118.
Phillips, M. R., Zhang, J., Shi, Q., Song, Z., Ding, Z., Pang, S., et al. (2009). Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001–2005: An epidemiological survey. Lancet, 373(9680), 2041.
Thompson, A., Hunt, C., & Issakidis, C. (2004). Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample. Social Psychiatry & Psychiatric Epidemiology, 39(10), 810.
Walker, E. R., & Druss, B. G. (2015). Rate and predictors of persistent major depressive disorder in a nationally representative sample. Community Mental Health Journal, 51(6), 701–707.
Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., et al. (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. The Lancet, 370(9590), 841–850.
Wong, D. F. K., Zhuang, X. Y., Pan, J. Y., & He, X. S. (2014). A critical review of mental health and mental health-related policies in China: More actions required. International Journal of Social Welfare, 23(2), 195–204.
Yang, L. H. (2007). Application of mental illness stigma theory to Chinese societies: Synthesis and new directions. Singapore Medical Journal, 48(11), 977–985.
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The study was supported by grants from the Three-year Action Program of Shanghai Municipality Strengthening Construction of Public Mental Health System (Grant No. GWVI-5) and the Shanghai Mental Health Center.
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Zhao, K., He, Y., Zeng, Q. et al. Factors of Mental Health Service Utilization by Community-Dwelling Adults in Shanghai, China. Community Ment Health J 55, 161–167 (2019). https://doi.org/10.1007/s10597-018-0352-7
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DOI: https://doi.org/10.1007/s10597-018-0352-7