title: Do users of mental health services lack access to general practitioner services?
abstract: OBJECTIVE
  To compare rates of visits to a general practitioner between users and non-users of mental health services (MHS).
  
  
  METHODS
  Population-based retrospective cohort study of 204 727 users and 294 076 matched non-users of MHS in Western Australia from 1 January 1990 to 30 June 2006, based on linked records of the use of MHS, hospital admissions, Medicare claims for GP and specialist services, electoral roll registration and deaths.
  
  
  METHODS
  Adjusted rate ratios (ARRs) for the number of visits to GPs by users of MHS relative to non-users, and for different categories of mental disorders.
  
  
  RESULTS
  Relative to non-users of MHS, the ARR of visits to GPs by users of MHS was 1.622 (95% CI, 1.613-1.631) overall, and was elevated in each separate category of mental illness. ARRs were highest for alcohol/drug disorders, schizophrenia and affective psychoses (2.404, 1.834 and 1.798, respectively). The results were not changed by location (metropolitan, rural or remote addresses). However, the 4% of MHS users with no fixed address had a very low ARR of visits to GPs (0.058; 95% CI, 0.057-0.060).
  
  
  CONCLUSIONS
  Users of MHS visit GPs substantially more often than non-users, with the exception of those with no fixed address who seldom see a GP at all.
authors.affiliation: University of Western Australia, Perth, WA, Australia. Qun.Mai@uwa.edu.au
authors.forename: Qun
authors.initials: Q
authors.lastname: Mai
authors.forename: C D'Arcy J
authors.initials: CD
authors.lastname: Holman
authors.forename: Frank M
authors.initials: FM
authors.lastname: Sanfilippo
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Emery
authors.forename: Louise M
authors.initials: LM
authors.lastname: Stewart
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000145:classification; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014904:Western Australia