The identification of young people's emotional distress: a study in primary care.
BACKGROUND
Primary care is a key step in young people's pathway to mental health care. Despite the high prevalence of mental disorder in this age group, little is known about the factors that determine the identification of young people's mental disorder in primary care.


OBJECTIVE
To provide a detailed description of the factors associated with both 'correct' and 'excessive' identification of youth mental disorder in primary care.


METHODS
Cross-sectional study.


METHODS
Twenty-six randomly selected general practices in Victoria, Australia.


METHODS
Consecutive young people (16-24 years) were interviewed before their consultation, using a semi-structured interview. They completed Kessler's scale of emotional distress (K10). GPs completed a questionnaire after the consultation. Multinomial logistic regression was used to examine the factors associated with GP identification of mental disorder in those with high and low probability of disorder on the K10.


RESULTS
Altogether, 450/501 (90%) of approached young people participated; 36.1% (95% confidence interval [CI] = 32.3 to 40.2%) had high probability of mental disorder on the K10. Young people's perception that they had a mental illness was highly associated with GP identification (odds ratio [OR] = 62.6, 95% CI = 22.8 to 172.0). Other significantly associated factors were: patient fears (OR = 2.4, 95% CI = 1.1 to 5.1), frequent consultations (OR = 3.0, 95% CI = 1.0 to 8.4), days out of role (OR = 2.7, 95% CI = 1.2 to 5.7), and continuity of care (OR = 3.4, 95% CI = 1.6 to 6.9). The latter two were also associated with 'over-identification' of young people who had low probability of mental disorder. GP characteristics were not associated with identification.


CONCLUSIONS
These findings provide guidance for GPs in their clinical work and training. They should also inform the further development of mental health literacy programmes in the community.
Haller
Dagmar M
DM
Department of Community Medicine and Primary Care, Geneva University Hospitals and University of Geneva, Switzerland. dagmar.haller-hester@hcuge.ch
Sanci
Lena A
LA
Sawyer
Susan M
SM
Patton
George C
GC
D000293:Adolescent; D001294:Attitude to Health; D004812:Epidemiologic Methods; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult