Nicolas Chauliac : " Unmet Needs in Mental Health: A Mixed Method Study "
Unmet needs in mental health care are a prominent issue, and concern almost half of people with such disorders. Psymobile is a mobile outreach psychiatric team whose objective is to facilitate access to psychiatric services. Its intervention is at the request of relatives or social workers, making it possible to encounter situations of long-standing unmet needs.
Our objective was to understand the barriers to accessing mental health care through:
• A qualitative study focusing on barriers to accessing mental health care, as seen by patients and relatives;
• An analysis of environmental sociological, demographic, economic and geographic factors in unmet needs.
Methods:
• Interviews with patients and relatives focusing on barriers to accessing mental health care;
• Principal Component Analysis (PCA) applied to the neighbourhood (IRIS) of each patient; we also used hierarchical agglomerative clustering (HAC) to create a taxonomy of neighbourhoods with 6 classes.
Results:
• Patients and their relatives cite anosognosia or lack of insight as a primary barrier, as are fear of stigma, and former negative experiences. The complexity of the French care system and the lack of literacy about mental illnesses were also emphasized by the participants. Physical determinants, such as the distance to healthcare facilities, were rarely mentioned.
• Regarding environmental characteristics, the first dimension of the PCA clustered the proportion of immigrants, unemployment rate, part of foreigners, as well as not being a homeowner, and the proportion of single-parent households. The second axis grouped neighbourhoods with a high proportion of one-person households, and a high density of population.
