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HEALTH SERVICE UTILISATION
Health service utilisation relates to services used for mental health problems in the 12 months prior to interview. While people were asked whether their use of health services related to a mental health problem, it is not possible to directly link this with specific mental disorders. A mental health problem in this context, may relate to stress, worry, sadness, or to any issue identified by the person, regardless of whether or not they met criteria for a mental disorder. Also, the treatment sought and/or received may relate to a mental disorder not collected in the survey, such as an eating disorder. Therefore, while it is possible to analyse the use of health services by people with a mental disorder, it is not possible to directly link service use with specific mental disorders.
CONSULTATIONS FOR SPECIFIC MENTAL DISORDERS
For each specific mental disorder (eg depression), information was collected about the type of treatment sought and received. People were asked whether they had ever talked to a medical doctor or other professional about symptoms previously identified (eg sadness, discouragement, lack of interest). The types of professionals include:
People were asked to provide their age in years for the first time they ever talked to a professional about their symptoms. For people who had talked to a professional during their lifetime, they were asked whether they had ever received treatment for their symptoms which they considered to be helpful or effective. People who had received helpful/effective treatment were then asked to:
People who had sought treatment, but had not received treatment they considered to be helpful/effective were also asked how many professionals they had ever talked to about their symptoms.
People who had received treatment during their lifetime were also asked:
COMPARISON WITH THE 1997 SURVEY
The 1997 survey contained one question on treatment seeking behaviour for each mental disorder. People were asked whether they had told a doctor about the symptoms or problems they had been experiencing. Some of these questions specifically referred to the 12 months prior to interview, but for others this was inferred through the scope of the survey. Additionally, at the end of each mental disorder module (eg Anxiety disorders) people were asked how many times they had seen a doctor or other health professional for their symptoms or problems (eg unusually strong fears, avoidance, feeling worried, etc) in the four weeks prior to interview.
SERVICES USED FOR MENTAL HEALTH PROBLEMS
This section provides information on the following types of service use:
CONSULTATIONS WITH HEALTH PROFESSIONALS
Information was collected on whether people had ever had consultations with the following types of health professionals (apart from any occurring during hospital admissions):
People who endorsed that they had seen a health professional for problems with their mental health were asked the first time (age in years) they ever saw that type of health professional for their mental health.
People who reported they had consultations with health professionals (including GPs) were asked to identify for the 12 months prior to interview:
People who did not know or were unable to provide information on the number of consultations they had in the 12 months prior to interview were asked about health consultations in their lifetime. They were asked whether they had ever seen a health professional for problems with their mental health.
Cost of consultations
People who saw a GP were asked to provide the average cost, not including any money refunded by Medicare or private health insurance, of a typical consultation. This was recorded as an 'out of pocket' expense. People may not have had any of these expenses, as they may have had their consultations bulk billed.
People who saw a health professional, other than a GP, were asked to nominate how they paid for their consultation from the following list:
They were also asked whether there were any 'out of pocket' expenses incurred by them, their friend/s or family member/s in paying for the consultations.
Health consultations with a GP
People who had more than one consultation with a GP for their mental health in the 12 months prior to interview, were asked about their continuity of care, including:
People who reported consultations with a GP in the 12 months prior to interview were also asked whether any of their consultations were:
People were asked whether they had ever been admitted to hospital for any reason, excluding routine childbirth. If a person endorsed that they had been admitted overnight they were asked how many times this had ever occurred and their age (in years) the first time they were admitted.
For the 12 months prior to interview, people were asked about hospital admissions relating to their physical and/or mental health problems. Mental health problems included, but were not restricted to, things such as stress, anxiety, depression, or dependence on alcohol or drugs. They were asked to provide:
Most recent hospital admission
People were asked the reason/s for their most recent hospital admission for physical and/or mental health problems. From a list provided, they were asked to nominate the main reason for admission. People were able to nominate more than one reason. The lists of reasons varied between physical and mental health problems.
Admission to treat physical health problems
Admission to treat mental health problems
Apart from the consultations with health professionals outlined previously, people were asked about any self-management strategies they may have used for their mental health problems. Information was collected about the use of:
For each of these, people were asked whether their use occurred in their lifetime, in the 12 months prior to the survey and if so, how many times they used this type of help and the average length of time for the help sessions.
People were also asked about other types of strategies they may have used for their mental health, including:
COMPARISON WITH THE 1997 SURVEY
Consultations with health professionals
Apart from the overall differences in the two surveys, in 1997 people were asked if they saw a doctor or health professional for their health, including check-ups or scripts, from a much broader list of options. Other specific health professionals that may have been identified include:
Additionally, in 1997 people were not specifically asked if they saw a mental health nurse, occupational therapist, cardiologist, or complementary/alternative therapist.
People were asked to identify the number of consultations with each group of professionals, as well as where the consultations mainly took place. In 1997, there were three additional categories to select from:
In 1997, people were asked about the number of admissions to general hospitals and the number of admissions for nerves or mental problems. People were also asked about the number of admissions to psychiatric hospitals and to drug and alcohol rehabilitation centres. For each type of admission, people were asked to identify whether they were in a public or private bed and the total number of nights spent in the hospital or unit.
The 1997 survey did not collect information on self-management strategies.
People were asked about the types of medications they had used for their mental health in the two weeks prior to interview. Up to five types of medication could be recorded. Medications include those used for preventive health purposes, as well as those used for mental disorders. Medications may have included:
People were also asked to report:
Most of the reported medications were automatically categorised through a Computer-Assisted Coding system (CAC). The CAC incorporates the names of medications readily available in Australia and commonly used for the nominated conditions. People were encouraged to refer to the medication packet, bottle, etc when reporting, but may have reported from memory or may have reported medications by their brand, trade or generic names. A small number of medications, which could not be identified by the CAC were manually categorised by ABS staff.
The medications reported for this survey were classified by generic type using a classification system developed by the ABS for the National Health Survey (cat. no. 4364.0). The classification system is based on the World Health Organization's (WHO) Anatomical Therapeutic Chemical (ATC) Classification and the framework (based on organ system and therapeutic drug class) underlying the listing of medications in the Australian Medicines Handbook.
For more information on the classification of medications, refer to the National Health Survey: Users' Guide - Electronic Publication, 2004-05 (cat. no. 4363.0.55.001).
COMPARISON WITH THE 1997 SURVEY
The 1997 survey did not collect information on medications.
PERCEIVED NEED FOR HELP
TYPES OF ASSISTANCE
Whether people had a perceived need for help was assessed in relation to five types of assistance:
WHETHER PERCEIVED NEED WAS MET
Responses to the perceived need for help questions were classified as:
WHETHER PEOPLE USED SERVICES
People who used services for mental health problems (ie consulted a health professional or were admitted to hospital overnight) in the 12 months prior to interview were asked to identify the help they received from a list of five types of assistance (see 'Types of assistance'). For each type of assistance, they were asked if they received as much help as they needed and if not, the main reason this was not received.
People who did not use services for mental health problems, but who had symptoms that indicated a potential mental disorder (eg feeling sad or uninterested, excitable or irritable, worried or anxious, problems with alcohol use or drugs, etc) were asked whether they felt they needed any help from a list of five types of assistance (see 'Types of assistance'). For each type of assistance identified, people were asked the main reason they did not seek help.
The following list provides the selection of main reasons:
Where a person said they preferred to manage their own mental health, they were asked to choose a main reason why they did not seek help from health professionals from the following list:
If a person had seen more than one type of health professional for their mental health problems in the 12 months prior to interview, they were asked to select who was most involved in providing them with the type of assistance they needed (eg information, medication, etc) from the following list:
If a person had seen only one type of health professional then this was recorded as the response.
COMPARISON WITH THE 1997 SURVEY
The 1997 survey asked about people's perceived need for help and whether their need was met in relation to the use of services for mental health problems. A new question was added in 2007 for people who indicated that they preferred to manage their own mental health. They were asked to choose a main reason why they did not seek help from health professionals.
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