ABSTRACT
OBJECTIVE: To examine the rate at which adults seek services for mental disorders from different categories of physicians. METHOD: The study used billing data from all physicians during a 3-year period for the total adult population of the province of Alberta. RESULTS: During the 3-year period, 35% of adults consulted a physician and were given a mental disorder diagnosis. The highest rates of consultation were for anxiety disorders (21%), followed by mood disorders (depression) (16%). Among patients, 84% were seen by primary care physicians only, and 3% were seen solely by psychiatrists. The more serious the diagnosing (for example, psychosis) the more likely patients were to be seen by psychiatrists. CONCLUSIONS: These results show that the 3-year prevalence rate includes more than one-third of the entire adult population. These figures differ considerably from those derived from population surveys in showing markedly higher prevalence (and treatment) rates. The number of people treated in primary care far exceeds those treated in the specialist sector.
Subject(s)
Mental Disorders/epidemiology , Referral and Consultation/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Alberta , Anxiety Disorders/epidemiology , Anxiety Disorders/therapy , Bipolar Disorder/epidemiology , Bipolar Disorder/therapy , Cross-Sectional Studies , Dementia/epidemiology , Dementia/therapy , Depressive Disorder/epidemiology , Depressive Disorder/therapy , Female , Health Surveys , Humans , Male , Mental Disorders/therapy , Middle Aged , Referral and Consultation/trends , Schizophrenia/epidemiology , Schizophrenia/therapy , Substance-Related Disorders/epidemiology , Substance-Related Disorders/therapy , Utilization Review/statistics & numerical data , Young AdultABSTRACT
OBJECTIVE: In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. METHODS: The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. RESULTS: The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). CONCLUSIONS: Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.
