Dataset Information

Marital separation and contact with primary healthcare services for mental health problems: a register-based study.

ABSTRACT: BACKGROUND:Marital separation is associated with mental health problems, but little is known about how this translates into healthcare use. In this study, we examine the relationship between marital separation and primary healthcare use for mental health problems. METHODS:We used data covering the period from 2005 to 2015 from the Norwegian Population Register, Statistics Norway's Educational Registration System and the Norwegian Health Economics Database. Data were analyzed using logistic regression analysis. To control for time invariant characteristics, we estimated fixed-effect models. RESULTS:Marital separation was associated with increased contact with primary healthcare services for mental health problems (MH-consultations). The prevalence of MH-consultations peaked during the year of marital separation. MH-consultations were more common following marital separation than prior to the separation. This pattern remained significant in the fixed-effect models. CONCLUSIONS:Men and women who experienced marital separation were more likely to consult primary healthcare services for mental health problems than those who remained married. Our study suggests that several mechanisms are in play. The prevalence of MH-consultations of those who eventually separated were higher several years prior to the separation. This lends support to selection mechanisms, whereas the sharp rise in the prevalence of MH-consultations around the time of marital separation coupled to higher levels several years after separation, indicate that marital separation induces both transient stress and leads to more lasting strain.

SUBMITTER: Reneflot A

PROVIDER: S-EPMC7687816 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Marital separation and contact with primary healthcare services for mental health problems: a register-based study.

Reneflot Anne A Øien-Ødegaard Carine C Hauge Lars Johan LJ

BMC psychology 20201125 1

<h4>Background</h4>Marital separation is associated with mental health problems, but little is known about how this translates into healthcare use. In this study, we examine the relationship between marital separation and primary healthcare use for mental health problems.<h4>Methods</h4>We used data covering the period from 2005 to 2015 from the Norwegian Population Register, Statistics Norway's Educational Registration System and the Norwegian Health Economics Database. Data were analyzed using ...[more]

PMID: 33239078

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Project description:OBJECTIVES:To identify a generic set of face valid quality indicators for primary care mental health services which reflect a multi-stakeholder perspective and can be used for facilitating quality improvement. DESIGN:Modified two-round postal Delphi questionnaire. SETTING:Geographical spread across Great Britain. PARTICIPANTS:One hundred and fifteen panellists representing 11 different stakeholder groups within primary care mental health services (clinical psychologist, health and social care commissioner, community psychiatric nurse, counsellor, general practitioner, practice nurse/district nurse/health visitor, psychiatrist, social worker, carer, patient and voluntary organisations). MAIN OUTCOME MEASURES:Face validity (median rating of 8 or 9 on a nine point scale with agreement by all panels) for assessing quality of care. RESULTS:A maximum of 334 indicators were rated by panels in the second round; 26% were rated valid by all panels. These indicators were categorised into 21 aspects of care, 11 relating to general practices and 10 relating to health authorities or primary care groups/trusts. There was variation in the total number of indicators rated valid across the different panels. Overall, GPs rated the lowest number of indicators as valid (41%, n=138) and carers rated the highest number valid (91%, n=304). CONCLUSIONS:The quality indicators represent consensus among key stakeholder groups in defining quality of care within primary care mental health services. These indicators could provide a guide for primary care organisations embarking on quality improvement initiatives in mental health care when addressing national targets and standards relating to primary care set out in the National Service Framework for Mental Health for England. Although many of the indicators relate to parochial issues in UK service delivery, the methodology used in the development of the indicators could be applied in other settings to produce locally relevant indicators.

Project description:ImportanceIn adulthood and adolescence, mental health vulnerability is known to be associated with risk of criminal justice system contact as both a perpetrator and survivor of crime, but whether this association is apparent early in child development is unknown. Prevention of poor outcomes, including repeated contact with the criminal justice system, relies on the identification of vulnerability early in life and at the start of such contact.ObjectiveTo ascertain whether children with emotional or behavioral problems and general developmental vulnerabilities are at an increased risk of subsequent contact with police as a person of interest, a survivor of crime, or a witness.Design, setting, and participantsThis cohort study used routinely collected data from the New South Wales Child Development Study in Australia. The cohort was composed of children who entered full-time schooling in New South Wales in 2009, had complete data for the emotional maturity domain of the Australian Early Development Census, and had no police contact before January 1, 2009. The children in the cohort were followed up until the age of 13 years. Data were analyzed from October 17, 2019, to May 13, 2020.ExposuresEmotional or behavioral problems and developmental risk profiles derived from the teacher-rated Australian Early Development Census.Main outcomes and measuresIncidence rates of police contact (as a person of interest, survivor of crime, or witness) were derived from the New South Wales Police Force Computerised Operational Policing System.ResultsA total of 79 801 children (40 584 boys [50.9%]; 2009 mean [SD] age, 5.2 [0.37] years) were included. Children with teacher-identified emotional or behavioral problems at school entry had an incidence rate of police contact (for any reason) that was twice that of children without such problems (unadjusted hazard ratio [HR], 2.14; 95% CI, 1.94-2.37). Contact with police as a survivor of crime was most commonly recorded (7350 [9.2%]), but the strength of the association was greatest between emotional or behavioral problems and police contact as a person of interest (unadjusted HR, 4.75; 95% CI, 3.64-6.19). Incidence of police contact as a person of interest was high for children with a pervasive developmental risk profile (unadjusted HR, 13.80; 95% CI, 9.79-19.45).Conclusions and relevanceThis study found an association of emerging emotional or behavioral problems and developmental vulnerabilities with increased risk of police contact for any reason among young children, suggesting that this well-known association in adults and adolescents can be identified at an earlier developmental stage. These findings support primary and secondary interventions to prevent police contact early in life and to target the earliest contacts with the criminal justice and educational systems.

Project description:BackgroundOver the past decades, the deficient provision of evidence-based interventions for the prevention and treatment of mental health problems has become a global challenge across health care systems. In view of the ongoing diffusion of new media and mobile technologies into everyday life, Web-delivered electronic mental health (e-mental health) treatment services have been suggested to expand the access to professional help. However, the large-scale dissemination and adoption of innovative e-mental health services is progressing slowly. This discrepancy between potential and actual impact in public health makes it essential to explore public acceptability of e-mental health treatment services across health care systems.ObjectiveThis scoping review aimed to identify and evaluate recent empirical evidence for public acceptability, service preferences, and attitudes toward e-mental health treatments. On the basis of both frameworks for technology adoption and previous research, we defined (1) perceived helpfulness and (2) intentions to use e-mental health treatment services as indicators for public acceptability in the respective general population of reviewed studies. This mapping should reduce heterogeneity and help derive implications for systematic reviews and public health strategies.MethodsWe systematically searched electronic databases (MEDLINE/PubMed, PsycINFO, Psyndex, PsycARTICLES, and Cochrane Library, using reference management software for parallel searches) to identify surveys published in English in peer-reviewed journals between January 2010 and December 2015, focusing on public perceptions about e-mental health treatments outside the context of clinical, psychosocial, or diagnostic interventions. Both indicators were obtained from previous review. Exclusion criteria further involved studies targeting specific groups or programs.ResultsThe simultaneous database search identified 76 nonduplicate records. Four articles from Europe and Australia were included in this scoping review. Sample sizes ranged from 217 to 2411 participants of ages 14-95 years. All included studies used cross-sectional designs and self-developed measures for outcomes related to both defined indicators of public acceptability. Three surveys used observational study designs, whereas one study was conducted as an experiment investigating the impact of brief educational information on attitudes. Taken together, the findings of included surveys suggested that e-mental health treatment services were perceived as less helpful than traditional face-to-face interventions. Additionally, intentions to future use e-mental health treatments were overall smaller in comparison to face-to-face services. Professional support was essential for help-seeking intentions in case of psychological distress. Therapist-assisted e-mental health services were preferred over unguided programs. Unexpectedly, assumed associations between familiarity with Web-based self-help for health purposes or "e-awareness" and intentions to use e-mental health services were weak or inconsistent.ConclusionsConsidering the marginal amount and heterogeneity of pilot studies focusing on public acceptability of e-mental health treatments, further research using theory-led approaches and validated measures is required to understand psychological facilitator and barriers for the implementation of innovative services into health care.

Dataset Information

Marital separation and contact with primary healthcare services for mental health problems: a register-based study.

Publications

Marital separation and contact with primary healthcare services for mental health problems: a register-based study.

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