Use of general practitioners versus mental health professionals in six European countries: the decisive role of the organization of mental health-care systems.
OBJECTIVE
To investigate patterns of use of general practitioners (GPs) and/or mental health professionals (MHPs) for mental health reasons, across six European countries, and the extent to which these patterns of use are associated with differences in mental health-care delivering systems.


METHODS
Data are based on the European Study of the Epidemiology of Mental Disorders (ESEMeD): a cross-sectional survey of a representative sample of 8,796 non-institutionalized adults from six European countries, conducted between 2001 and 2003 using computer-assisted interviews with the CIDI-3.0. Countries were classified into: MHP- for countries where access to medical professionals tends to predominate (Belgium, France, Italy), and MHP+ where access to non-medical MHPs predominates (Germany, Spain, The Netherlands).


RESULTS
Among respondents consulting GPs and/or MHPs in the past year (n = 1,019), respondents from the MHP- group more often consulted GPs (68 vs. 55 % in MHP+ group), GPs and psychiatrists (23 vs. 14 %). People from the MHP+ group more often used MHPs only (45 vs. 32 %), GPs and non-medical MHPs (16 vs. 8 %). GPs from the MHP+ group were more inclined to refer patients to MHPs. Factors associated with use of GPs versus MHPs were: being over 49 years, not highly educated, lower income and suffering from mood or severe mental disorders.


CONCLUSIONS
Differences in the use of GPs versus MHPs are markedly linked to individual as well as organizational factors. Interventions are needed, in countries fostering medical access, to reimburse sessions with non-medical MHPs and improve cooperation between professionals to obtain better practice in access to care.
EA4069 Ecole des Hautes Etudes en Santé Publique (EHESP), Hôtel Dieu, Paris Descartes University, Sorbonne Paris Cité, 1 place du parvis de Notre-Dame, 75181, Paris Cedex 04, France. anne.dezetter@parisdescartes.fr
Anne
A
Dezetter
X
X
Briffault
R
R
Bruffaerts
R
R
De Graaf
J
J
Alonso
H H
HH
König
J M
JM
Haro
G
G
de Girolamo
G
G
Vilagut
V
V
Kovess-Masféty
D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration*; D005060:Europe / Q000453:epidemiology; D005260:Female; D058005:General Practitioners; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D010820:Physicians; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011570:Psychiatry; D011613:Psychotherapy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult