Unmet mental health needs in the general population: perspectives of Belgian health and social care professionals.


Journal

International journal for equity in health
ISSN: 1475-9276
Titre abrégé: Int J Equity Health
Pays: England
ID NLM: 101147692

Informations de publication

Date de publication:
29 09 2020
Historique:
received: 04 06 2020
accepted: 23 09 2020
entrez: 30 9 2020
pubmed: 1 10 2020
medline: 7 2 2021
Statut: epublish

Résumé

An unmet mental health need exists when someone has a mental health problem but doesn't receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups. Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants' professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis. Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs. Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients' perspective of unmet mental health needs.

Sections du résumé

BACKGROUND
An unmet mental health need exists when someone has a mental health problem but doesn't receive formal care, or when the care received is insufficient or inadequate. Epidemiological research has identified both structural and attitudinal barriers to care which lead to unmet mental health needs, but reviewed literature has shown gaps in qualitative research on unmet mental health needs. This study aimed to explore unmet mental health needs in the general population from the perspective of professionals working with vulnerable groups.
METHODS
Four focus group discussions and two interviews with 34 participants were conducted from October 2019 to January 2020. Participants' professional backgrounds encompassed social work, mental health care and primary care in one rural and one urban primary care zone in Antwerp, Belgium. A topic guide was used to prompt discussions about which groups have high unmet mental health needs and why. Transcripts were coded using thematic analysis.
RESULTS
Five themes emerged, which are subdivided in several subthemes: (1) socio-demographic determinants and disorder characteristics associated with unmet mental health needs; (2) demand-side barriers; (3) supply-side barriers; (4) consequences of unmet mental health needs; and (5) suggested improvements for meeting unmet mental health needs.
CONCLUSIONS
Findings of epidemiological research were largely corroborated. Some additional groups with high unmet needs were identified. Professionals argued that they are often confronted with cases which are too complex for regular psychiatric care and highlighted the problem of care avoidance. Important system-level factors include waiting times of subsidized services and cost of non-subsidized services. Feelings of burden and powerlessness are common among professionals who are often confronted with unmet needs. Professionals discussed future directions for an equitable mental health care provision, which should be accessible and targeted at those in the greatest need. Further research is needed to include the patients' perspective of unmet mental health needs.

Identifiants

pubmed: 32993667
doi: 10.1186/s12939-020-01287-0
pii: 10.1186/s12939-020-01287-0
pmc: PMC7526210
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

169

Références

Calif J Health Promot. 2017;15(1):36-45
pubmed: 28729814
J Health Psychol. 2017 Jan;22(1):51-67
pubmed: 26220460
Int J Equity Health. 2019 Aug 5;18(1):122
pubmed: 31382979
JAMA. 2004 Jun 2;291(21):2581-90
pubmed: 15173149
Psychol Med. 2014 Apr;44(6):1303-17
pubmed: 23931656
Br J Psychiatry. 2017 Apr;210(4):261-268
pubmed: 28153928
Soc Psychiatry Psychiatr Epidemiol. 2011 Oct;46(10):1033-44
pubmed: 20686887
Health Policy Plan. 2004 Mar;19(2):69-79
pubmed: 14982885
Int J Epidemiol. 2014 Apr;43(2):476-93
pubmed: 24648481
Int J Soc Psychiatry. 2002 Sep;48(3):163-76
pubmed: 12413245
Health Aff (Millwood). 2017 Oct 1;36(10):1739-1747
pubmed: 28971918
Acta Psychiatr Scand Suppl. 2004;(420):47-54
pubmed: 15128387
Can J Psychiatry. 2015 Jun;60(6):284-93
pubmed: 26175326
Psychiatr Serv. 2016 Jan;67(1):78-85
pubmed: 26325455
Can J Psychiatry. 2017 Aug;62(8):551-559
pubmed: 28616935
Soc Psychiatry Psychiatr Epidemiol. 2017 Aug;52(8):1005-1013
pubmed: 28456871
J Gen Intern Med. 2007 Jun;22(6):852-63
pubmed: 17375358
Int J Equity Health. 2018 Feb 20;17(1):28
pubmed: 29458379
Am J Public Health. 2002 Jan;92(1):92-8
pubmed: 11772769
Psychol Med. 2011 Aug;41(8):1751-61
pubmed: 21134315
Psychiatr Serv. 2007 Mar;58(3):357-64
pubmed: 17325109
J Nerv Ment Dis. 2016 Apr;204(4):321-4
pubmed: 27015396
Can J Psychiatry. 2005 Sep;50(10):643-51
pubmed: 16276856
Arch Gen Psychiatry. 2005 Jun;62(6):629-40
pubmed: 15939840
Lancet. 2007 Sep 8;370(9590):841-50
pubmed: 17826169
Psychiatr Serv. 2006 Jun;57(6):795-802
pubmed: 16754755
BMC Psychiatry. 2010 Dec 02;10:103
pubmed: 21126334
Arch Gen Psychiatry. 2002 Jan;59(1):77-84
pubmed: 11779286
Psychiatr Serv. 2009 Aug;60(8):1051-8
pubmed: 19648192
Int J Equity Health. 2013 Mar 11;12:18
pubmed: 23496984
Int J Health Plann Manage. 2019 Apr;34(2):761-772
pubmed: 30657197
Br J Psychiatry. 2007 Apr;190:299-306
pubmed: 17401035
BMC Psychiatry. 2018 Aug 22;18(1):262
pubmed: 30134869

Auteurs

Eva Rens (E)

Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium. eva.rens@uantwerpen.be.
Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium. eva.rens@uantwerpen.be.

Geert Dom (G)

Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.

Roy Remmen (R)

Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium.

Joris Michielsen (J)

Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.
AZ KLINA, Brasschaat, Belgium.

Kris Van den Broeck (K)

Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.
Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH