title: Seeking mental health care from private health practitioners among individuals with alcohol dependence/abuse; results from a study in the French general population.
abstract: Better knowledge of the factors that have an impact on pathways to mental health care may contribute greatly to organizing optimum health-care delivery. However, surveillance systems concerning alcohol problems in the French general population are suboptimal. The objectives of this study were to investigate: 1) the prevalence of mental health-care seeking in individuals with alcohol abuse/dependence in France, 2) which category of medical practitioner was consulted, and 3) psychological and socio-environmental factors associated with mental health-care seeking.
  
  
  
  A total sample of 22,138 individuals was interviewed in a telephone survey. Individual data on alcohol dependence/abuse and other mental health disorders were collected using the Composite International Diagnosis Interview - short form. Mental health-care seeking was assessed, together with data on living conditions, deprivation, and self-reported drinking problems. Only respondents meeting criteria for alcohol dependence/abuse were included in analyses.
  
  
  
  Less than half of the 722 respondents with alcohol abuse/dependence had sought mental health care in the preceding 12 months, of whom 90.5% consulted their general practitioner (GP) (56.1%), or both a general practitioner and a psychiatrist (34.4%). Mental health-care seeking was associated with female sex, previous alcohol discussion with a doctor, and the presence of psychiatric comorbidities arising in the preceding 12 months. Living environment, socio-economic status, or self-reported drinking problems had no influence.
  
  
  
  A minority of people with alcohol abuse/dependence sought mental health care, mainly in relation to psychiatric comorbidities. In addition, most people consulting a GP were not referred to a psychiatrist. However, social deprivation and living in rural areas did not hinder mental health-care seeking among respondents. Adequate protocols to treat alcohol disorders could be implemented among private health-care providers to improve management of alcohol problems in France.
authors.affiliation: EHESP School of Public Health, Rennes, F-35043, France.
authors.forename: Aymery
authors.initials: A
authors.lastname: Constant
authors.affiliation: EHESP School of Public Health, Rennes, F-35043, France.
authors.forename: William
authors.initials: W
authors.lastname: Sherlaw
authors.affiliation: EHESP School of Public Health, Rennes, F-35043, France; Paris Descartes University, Paris, F-75006, France. Electronic address: Viviane.kovess@ehesp.fr.
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005602:France / Q000453:epidemiology; D058005:General Practitioners / Q000639:trends*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D008603:Mental Health; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods; D011331:Private Practice / Q000639:trends*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Alcohol abuse/dependence; Epidemiological survey; France; Mental health-care seeking; Private practitioners