ABSTRACT
OBJECTIVE: To investigate differences in 12-month prevalences of mental disorders and 12-month treatment contact among New Zealand born and migrants in separate ethnic groups in Te Rau Hinengaro: The New Zealand Mental Health Survey (NZMHS). DATA: The NZMHS is a nationally representative face-to-face household survey, carried out in 2003-2004 with a response rate of 73.3%. It surveyed 12,992 New Zealand adults aged 16 and over Pacific people were over sampled This paper focuses on the 2374 Pacific participants but includes for comparison 8160 non-Maori-non-Pacific participants (Others). METHOD: Multiple logistic regression models were used to produce estimates weighted to account for diferent probabilities of selection and taking account of the complex survey design. RESULTS: The prevalence of mental disorder was lowest among those who migrated as adults compared with those who migrated as young children (child migrants) or New Zealand-born (NZ born) migrant descendants in both Pacific and other ethnic groups. While Pacific people have higher rates of disorder than Others, many of the observed differences between Pacific and Others were explained by population differences in age and sex. Service use in the last 12 months by people with a disorder was low among Pacific peoples overall, but spec fically among older migrants. Older Pacific migrants with a disorder had particularly low use of specialist mental health services. CONCLUSION: An interesting picture has emerged regarding need for and use of mental health services. The burden of mental disorder is highest while service use was lower among Pacflc peoples generally Those born in or who migrated as children to New Zealand had higher levels of disorder but were also more likely to use services than older migrants.
Subject(s)
Ethnicity/psychology , Mental Disorders/epidemiology , Mental Health Services , Adolescent , Adult , Aged , Confidence Intervals , Cross-Sectional Studies , Data Collection , Emigration and Immigration , Female , Humans , Logistic Models , Male , Mental Disorders/ethnology , Mental Disorders/pathology , Mental Disorders/therapy , Middle Aged , Multivariate Analysis , New Zealand/epidemiology , Odds Ratio , Prevalence , Psychometrics , Risk Factors , Severity of Illness Index , Time Factors , Young AdultABSTRACT
OBJECTIVE: To describe reasons for admission and alternatives to admission in a government funded acute inpatient unit. METHOD: Reasons for admission and alternatives to admission were rated for a consecutive sample of 255 admissions to an acute psychiatric unit in Auckland, using interviews with staff and case note review. RESULT: Most patients had a functional psychosis and were admitted involuntarily. Forty percent came from areas of marked social deprivation. The major reasons for admission were for reinstatement of medication (mainly linked to non-concordance with prescribed medication), intensive observation, risk to self and risk to others. Only 12% of admissions could have been diverted, of whom most would have required daily home treatment. For those still admitted at 5 weeks, 26% could have been discharged, mainly to 24 h nurse-staffed accommodation. If the alternatives had all been available, simulated bed-day savings were 11 bed years per year. Simulated bed day savings were greater through implementing early discharge than by diverting new admissions. CONCLUSION: Greater availability of assertive community treatment and of interventions to improve medication concordance may have prevented a small number of admissions. For patients admitted longer than 5 weeks, it appeared that greater availability of 24 h nurse-staffed accommodation would have allowed considerable bed-day savings.
