Are young adults mental healths needs met at the local health care centre

1
Are young adults mental healths needs met at
the local health care centre?

• Pia Åsbring, PhD
• Intervention and implementation research
• Department of Public Health Sciences
• Karolinska Institutet
• Stockholm, Sweden

2
Background

• Young adults mental health has
  become worse the last 20
  years
  
• ..especially amongst the women
• There seem to be unfulfilled needs regarding help
  from the health care sector
  
• This is a public health problem

3
Aim

• The aim with this study was to find out if young
  adults that seek help for physical problems also
  describe that they have mental health problems
  and if these needs are met at the health care
  centre (HCC)

4
Material Method

• A questionnaire were created
• 4 health HCC in Stockholm County were selected
• The study was carried out during January - June
  2008
  
• 150 questionnaires was given out from each HHC to
  young people born in the eighties, regardless of
  cause to the visit
  
• A major part of the results are based on the open
  questions the respondents experiences and
  thoughts
  

5
The respondents

• Young adults, 18-28 years (mean age 23)
• that had visited one of the four HCCs
• for various health problems

6
Results 1/9

• 246 questionnaires was answered sent in
• Two thirds of the respondents were women
• The majority, 89, seeked help for only for
  physical illness and 6 only for mental
  illness
  
• But. 81 thought that their ill health depended
  entirely or partly on psychological/life related
  reasons
  

7
Results 2/9

• 51 considered their physical health as bad
• 45 considered their mental health as bad (57
  six months or more)
  
• A relation existed between their physical and
  mental health
  

8
Results 3/9

• 1/3 of those with mental problems told the
  physician about it
  
• 10 of those had seeked help for mental health
  problems and14 for physical problems
  
• Help for mental health problems receipt,
  referred to another health care giver, talk with
  the physician, sick-listed, time for a new
  appointment

9
Results 4/9

• 2/3 did not tell the physician about it. Why?
• - not relevant
• - lack of time
• - the experienced treatment during the encounter
• - the subject wasnt brought up
• - one did not consider oneself to have serious
  enough problems
  
• - the belief that you cannot seek help for more
  than one thing
  
• - did not want to burden the health care
  personnel
  
• - receive help elsewhere
• - fear of not being taken seriously or dismissed
• - shame

10
Results 5/9

• 57 believed that it is possible to get good help
  for mental illness at a HCC
  
• but 43 did not think so
• The men thought better about the HCCs in this
  matter
  
• Important which physician you meet and how big
  the problem is
  
• However, 91, were satisfied with the help they
  received at the HCC

11
Results 6/9

• Positive comments regarding the HCC
• Good as a first instance, there are knowledge and
  one can be referred to another caregiver (ex. to
  a social worker or psychologist)
  
• I trust the health care. If you cannot get the
  help needed there I believe/hope/trust that you
  will be referred to the right kind of care.
  
• They seemed courteous and nice but it is, its
  true, a health care center and not a
  psychology-unit.
  
• As long as you have the courage to talk about
  your problems Im sure its all right.

12
Results 7/9

• Negative comments regarding the HCC
• Stress during the encounter, focus on physical
  problems, the physicians does not have the right
  competence and can only refer the patient or
  write out receipts
• They seem to think that my mental illness does
  not belong to the health care domain. Here you
  only solve physical problems.
  
• He didnt feel reassuring, nobody that one would
  like to talk with
  
• The whole meeting was so short. I felt that I
  wanted to tell the physician more, but he showed
  me out immediately.

13
Results 8/9

• Only good help if one has serious mental health
  problems?
  
• I tried once, but it wasnt thought to be any
  need for help since I wasnt mentally ill and I
  would have to be on a waiting list for 3-4 months
  to have a talk with a psychologist
• The best alternative is an attempt to intoxicate
  oneself, then you get help immediately. Otherwise
  its a fight.
  
• I believe, unfortunately, that if you want to get
  help you have to exaggerate your problems. My
  friends have got help at the psychiatric
  emergency-department.

14
Results 9/9

• How can, then, the HCC help young adults with
  mental illness?
  
• - enough time for talk during the appointment
• - shorter waiting list to the social
  worker/psychologist
  
• - have a general picture of the problem
• - dare to bring the question up
• - take the mental health problems seriously
• - awareness about the stigma that is associated
  with mental illness
  
• - plainness about the possibility to receive help
  from the HCC
  
• Should be good with more information about that
  help/care is available and that it doesn't have
  to be that serious for one to seek help. Me
  myself waited probably three years too long. It
  made it much worse.

15
Summary

• Very few seeked help for their mental illness at
  the HCC.
  
• The physical problems often became the focus and
  the entrance-ticket. The mental problems was
  often hidden.
  
• The young peoples needs could not be said to be
  met at the HCC, unless they themselves bring up
  their problems.
  
• Plainness from the HCC about what help is
  available is needed

16
Discussion

• Reactions to the results?
• How are young people with mental health problems
  helped in other countries? Is there a clear
  strategy?

17
Thank you for listening!
18
Contact

• Pia Åsbring
• pia.asbring_at_ki.se