title: Males' mental health disadvantage: An estimation of gender-specific changes in service utilisation for mental and substance use disorders in Australia.
abstract: BACKGROUND
  Concerns about low levels of service utilisation for mental and substance use disorders in Australia - especially among males - have prompted targeted help-seeking and stigma-reduction initiatives. Resulting changes in service utilisation according to gender are unknown. We modelled the percentage of Australian males with a mental or substance use disorder who used services each year between 2006-2007 and 2011-2012, and the types of services they used, relative to females.
  
  
  METHODS
  Twelve-month prevalence of mental and substance use disorders, stratified by gender, was synthesised from existing estimates. The percentage of males and females with these disorders who used mental health services in each year from 2006-2007 to 2011-2012 was modelled from published programme activity data, supplemented by analyses of epidemiological survey data. Uncertainty analysis quantified the effects of sampling error and assumptions on the estimates.
  
  
  RESULTS
  Modelling showed a significant increase in the percentage of people with mental or substance use disorders who used services for their mental health - from 32.0% in 2006-2007 to 40.0% in 2011-2012 in males and from 45.1% in 2006-2007 to 54.6% in 2011-2012 in females. Growth was driven largely by uptake of private specialised services - males' use of these services grew by 92.7% and females' by 115.4%. There appeared to be a non-significant decrease in use of general practitioner-only mental health care for males (-17.9%), and a significant decrease in the same for females (-35.1%); however, some assumptions made in the modelling of general practitioner-only care require validation. In 2006-2007, the percentage of females treated was 40.9% higher than for males; in 2011-2012, it was 36.6% greater.
  
  
  CONCLUSIONS
  Recently implemented initiatives have improved males' likelihood of service utilisation, particularly their use of specialised mental health services. Although the gender gap may have narrowed, improving males' access to services should remain a policy priority.
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia harrism@qcmhr.uq.edu.au.
authors.forename: Meredith G
authors.initials: MG
authors.lastname: Harris
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Diminic
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Reavley
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Baxter
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Pirkis
authors.affiliation: School of Public Health, The University of Queensland, Herston, QLD, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, QLD, Australia.
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Whiteford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008571:Men; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: Gender; epidemiology; health services; mental disorders; substance use disorders