title: Factors associated with use of psychiatrists and nonpsychiatrist providers by ESEMeD respondents in six European countries.
abstract: OBJECTIVE
  This study analyzed use of services from psychiatrists and other mental health professionals (psychologists, psychotherapists, counselors, and social workers) in six European countries.
  
  
  METHODS
  Data were from respondents (N=8,796) to the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross-sectional survey (2001-2003) of a representative sample of noninstitutionalized adults in Belgium, France, Germany, Italy, the Netherlands, and Spain that was conducted via computer-assisted interviews with the Composite International Diagnostic Interview, version 3.0.
  
  
  RESULTS
  Twenty-three percent of respondents reported lifetime use of any professional for mental health problems, and 60% consulted a mental health provider. Among these, 56% used a psychiatrist and 68% used a nonpsychiatrist provider. Factors associated with use of psychiatrists only were being retired or unemployed, having 12 or fewer years of education, living in France or Spain, having a severe disorder, and using psychotropic medication. Factors associated with use of nonpsychiatrist providers only were living in the Netherlands or Germany, never being married, and having an anxiety disorder.
  
  
  CONCLUSIONS
  The findings suggest that there is no simple model of associations between mental health care system and patterns of service use. System characteristics, such as practitioner-population ratios, levels of practitioner availability, and gatekeeping and reimbursement policies, affect patterns of use of mental health providers. Recent British and Australian plans could be used as models for better allocation of services in some ESEMeD countries.
authors.affiliation: EA4069, Paris Descartes University, Ecole des Hautes Etudes en Santé Publique, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Dezetter
authors.forename: Xavier
authors.initials: X
authors.lastname: Briffault
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.forename: Mathias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.forename: Ron
authors.initials: R
authors.lastname: De Graaf
authors.forename: Josep M
authors.initials: JM
authors.lastname: Haro
authors.forename: Hans Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
mesh_terms: D000293:Adolescent; D000328:Adult; D001426:Bacterial Proteins; D001530:Belgium; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D007558:Italy; D008074:Lipoproteins; D016015:Logistic Models; D008297:Male; D008565:Membrane Proteins; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D016017:Odds Ratio; D011570:Psychiatry / Q000706:statistics & numerical data; D011586:Psychology, Clinical / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D008074:Lipoproteins; D008565:Membrane Proteins; C089313:SpaI protein, Bacillus subtilis