Dataset Information

The role of adverse physical health events on the utilization of mental health services.

ABSTRACT:

Objective

To test the degree to which adverse physical health events may subsequently increase the utilization of mental health services.

Methods

A quasi-experimental pretest-posttest design was employed on a nationally representative sample of adults from the Medical Expenditure Panel Surveys for years 2004 and 2005. We constructed a 2-year balanced-panel dataset on 6,017 U.S. adults who did not have any adverse physical health events in 2004. We calculated difference-in-differences estimators that capture the effect of adverse physical health events on provider visits and prescription drug use for the treatment of mental health conditions.

Principal findings

Our most rigorous analytic model shows that an adverse physical health event is significantly associated with more than a threefold increase in the likelihood of provider visits and prescribed medication use for the treatment of mental health problems. These increases are mainly through office-based physician visits for nonsevere mental health conditions. This relationship is greater among those who experience more severe physical health events.

Conclusion

An adverse physical health event substantially increases the utilization of mental health care. Mental health service use increases with the severity of a physical health condition.

SUBMITTER: Yoon J

PROVIDER: S-EPMC3589961 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background and Objectives: Schizophrenia, a debilitating mental illness, is often associated with significant physical health risks. Many second-generation antipsychotics increase the risk of metabolic syndrome and cardiovascular disease. Community pharmacists are highly accessible and could play a role in monitoring cardiometabolic adverse drug events in people with schizophrenia. However, it remains uncertain whether mental health professionals perceive this as valuable. This study aimed to explore the opinions of mental healthcare professionals regarding the role of community pharmacists in reducing the incidence of cardiometabolic adverse events in people with schizophrenia and their integration into a multidisciplinary mental health team. Materials and Methods: Qualitative semi-structured interviews were conducted with Australian psychiatrists, mental health nurses and mental health pharmacists. Transcription of the interviews underwent thematic analysis using an inductive approach. Results: Eleven mental healthcare professionals from metropolitan and regional areas across Australia were interviewed, leading to the identification of five overarching themes. These themes encompassed the following aspects: the benefits of community pharmacists' involvement in managing cardiometabolic adverse drug events in people with schizophrenia, improving communication pathways with community pharmacists, defining roles and responsibilities for monitoring cardiometabolic parameters and managing adverse cardiometabolic drug events, fostering collaboration between community pharmacists and mental health care professionals, and recognising the acceptance of community pharmacists' integration within a multidisciplinary team. Mental health professionals believed that community pharmacists could play a role in reducing the incidence of cardiometabolic adverse events in schizophrenia. However, they underscored the need for enhanced communication and collaboration pathways with other healthcare professionals, emphasised the importance of more comprehensive mental health first aid training, and identified potential barriers for community pharmacists such as remuneration, workload, and staff resources. Conclusions: Mental health professionals acknowledged the benefits of incorporating community pharmacists into multidisciplinary teams as a strategy to reduce the incidence of adverse events among individuals with schizophrenia. They recognise the competence of community pharmacists in monitoring cardiometabolic adverse events. However, these professionals have also highlighted specific perceived barriers to the complete integration of community pharmacists within these teams. Notably, there are concerns related to remuneration, staff resources, time constraints, acceptance by other healthcare professionals and patients, and the need for improved communication pathways. Addressing these barriers and providing targeted training could facilitate the valuable inclusion of community pharmacists in the comprehensive care of people with schizophrenia.