Differences in lifetime use of services for mental health problems in six European countries.
OBJECTIVE
In Europe mental health services vary somewhat in the level of resources available and in their organization. The purpose of this study was to describe lifetime use of mental health services in six European countries, especially by individuals with a DSM-IV-defined psychiatric disorder (psychotic disorders were excluded), and to assess differences between countries as a function of resource availability.


METHODS
Data were obtained from 8,796 noninstitutionalized adults of six European countries by computer-assisted interviews with the Composite International Diagnostic Interview, version 3.0.


RESULTS
Lifetime consultation rates varied between countries and according to mental health status. For depression, lifetime consultation rates ranged from 37.0% in Italy to 71.0% in the Netherlands. Among users of services, general practitioners were the professionals most frequently consulted in all countries (64.2% on average), followed by psychiatrists (consultation ranged from 25.5% in the Netherlands to 43.8% in Spain) and psychologists (consultation ranged from 23.3% in France to 64.8% in the Netherlands). The lowest rates were in the countries with the lowest availability of professionals, but the countries with the highest density of professionals did not necessarily have the highest consultation rates.


CONCLUSIONS
Although there are important differences in mental health care between European countries, they seem to be only partially related to differences in overall health care provision.
Kovess-Masfety
Viviane
V
Mutuelle Générale de l'Education Nationale (MGEN) Foundation for Public Health, EA 4069, University of Paris 5, Paris, France. vkovess@mgen.fr
Alonso
Jordi
J
Brugha
Traolach S
TS
Angermeyer
Matthias C
MC
Haro
Josep Maria
JM
Sevilla-Dedieu
Christine
C
D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D001008:Anxiety Disorders / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005060:Europe; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009313:National Health Programs / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000706:statistics & numerical data; D011586:Psychology, Clinical / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data