Mental disorders among young adults self-referred and referred by professionals to specialty mental health care.
OBJECTIVE
Psychiatric disorders among young adults are prevalent, although a minority seek treatment. The option of direct self-referral to specialty mental health care may lower the help-seeking threshold but may also lead to self-referral by those with symptoms but no diagnosable disorders. This study examined whether differences exist in morbidity and in past use of mental health services between self-referrals to specialty care and those referred by nonpsychiatrist professionals.


METHODS
Two hundred consecutive young adult outpatients from a medium-sized city in Sweden who visited a specialty psychiatric clinic were assessed with the Structured Clinical Interview for DSM-IV (axis I and II disorders). Previous mental health contacts were also assessed.


RESULTS
A total of 49 patients (25%) were self-referred and 151 (75%) were referred by nonpsychiatrist professionals. Mood disorders and specific phobia were more common among self-referred patients (p<.05 for both), but no other significant between-group differences in axis I or II disorders were found. No differences were found in number of current axis I disorders (2.3 for self-referred and 2.2 for the comparison group), number of lifetime diagnoses (2.9 and 2.9), self-reported age at onset (13.6 and 13.5 years), and GAF ratings (54.5 and 54.7). The proportion of patients with no previous mental health contacts was larger in the self-referred group (35% and 18%, p<.05).


CONCLUSIONS
No evidence was found that the option of direct self-referral to specialty mental health care increased help seeking or led to overuse of care, although the generalizability of findings to other settings is unknown.
Ramirez
Adriana
A
Department of Neuroscience, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.
Ekselius
Lisa
L
Ramklint
Mia
M
D000293:Adolescent; D017668:Age of Onset; D003430:Cross-Sectional Studies; D006300:Health Services Misuse / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013548:Sweden; D014600:Utilization Review; D055815:Young Adult