Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study

Abstract Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient’s link with Primary Care after admission to a Specialized Mental Health Services still need to be expl...

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Autores principales:	Carlos Alberto dos Santos Treichel, Ioannis Bakolis, Rosana Teresa Onocko-Campos
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Pathways to Care Mental Health Community Mental Health Services Primary care Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/ce0e92c8f1394ab39779707a91fe266d
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spelling	oai:doaj.org-article:ce0e92c8f1394ab39779707a91fe266d2021-12-05T12:09:52ZDeterminants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study10.1186/s13033-021-00507-61752-4458https://doaj.org/article/ce0e92c8f1394ab39779707a91fe266d2021-12-01T00:00:00Zhttps://doi.org/10.1186/s13033-021-00507-6https://doaj.org/toc/1752-4458Abstract Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient’s link with Primary Care after admission to a Specialized Mental Health Services still need to be explored in greater depth. Thus, this study aimed to evaluate the determinants of timely access to Specialized Mental Health Services (outcome 1) and maintenance of a link with Primary Care after patients’ admission (outcome 2). Methods This is a cross-sectional study, conducted with 341 users of Specialized Mental Health Services at outpatient and community level in a medium-sized city in Brazil between August and November 2019. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results Factors positively associated with timely access were the diagnosis of psychosis or psychoactive substance misuse. The inversely associated factors with this outcome were higher income, having their need for mental health care identified in an appointment for general complaints, having been referred to the current service by Primary Care, having attended the current service for up to 3 years and delay until the first appointment (in a previous service). Regarding the maintenance of a link with Primary Care, factors positively associated were being referred to the current service by Primary Care or private service and receiving visits from Community Health Agents. The inversely associated factors with this outcome were male sex, being employed, having a diagnosis of psychosis or psychoactive substance misuse, and a greater perception of social support. Conclusions In addition to individual factors, factors related to the organization of services and the referral between them stood out in influencing both the access and maintenance of the patients’ link with Primary Care. Thus, this study reinforces the idea that integration between Primary Care and Specialized Mental Health Services should be strengthened, both to reduce waiting times for between-service referrals and benefit of care continuity.Carlos Alberto dos Santos TreichelIoannis BakolisRosana Teresa Onocko-CamposBMCarticlePathways to CareMental HealthCommunity Mental Health ServicesPrimary careNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENInternational Journal of Mental Health Systems, Vol 15, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pathways to Care Mental Health Community Mental Health Services Primary care Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Pathways to Care Mental Health Community Mental Health Services Primary care Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Carlos Alberto dos Santos Treichel Ioannis Bakolis Rosana Teresa Onocko-Campos Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study
description	Abstract Background Although access to specialized services is one of the main components of the study of paths to mental health care worldwide, the factors related to the continuity of the patient’s link with Primary Care after admission to a Specialized Mental Health Services still need to be explored in greater depth. Thus, this study aimed to evaluate the determinants of timely access to Specialized Mental Health Services (outcome 1) and maintenance of a link with Primary Care after patients’ admission (outcome 2). Methods This is a cross-sectional study, conducted with 341 users of Specialized Mental Health Services at outpatient and community level in a medium-sized city in Brazil between August and November 2019. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results Factors positively associated with timely access were the diagnosis of psychosis or psychoactive substance misuse. The inversely associated factors with this outcome were higher income, having their need for mental health care identified in an appointment for general complaints, having been referred to the current service by Primary Care, having attended the current service for up to 3 years and delay until the first appointment (in a previous service). Regarding the maintenance of a link with Primary Care, factors positively associated were being referred to the current service by Primary Care or private service and receiving visits from Community Health Agents. The inversely associated factors with this outcome were male sex, being employed, having a diagnosis of psychosis or psychoactive substance misuse, and a greater perception of social support. Conclusions In addition to individual factors, factors related to the organization of services and the referral between them stood out in influencing both the access and maintenance of the patients’ link with Primary Care. Thus, this study reinforces the idea that integration between Primary Care and Specialized Mental Health Services should be strengthened, both to reduce waiting times for between-service referrals and benefit of care continuity.
format	article
author	Carlos Alberto dos Santos Treichel Ioannis Bakolis Rosana Teresa Onocko-Campos
author_facet	Carlos Alberto dos Santos Treichel Ioannis Bakolis Rosana Teresa Onocko-Campos
author_sort	Carlos Alberto dos Santos Treichel
title	Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study
title_short	Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study
title_full	Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study
title_fullStr	Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study
title_full_unstemmed	Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study
title_sort	determinants of timely access to specialized mental health services and maintenance of a link with primary care: a cross-sectional study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/ce0e92c8f1394ab39779707a91fe266d
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Determinants of timely access to Specialized Mental Health Services and maintenance of a link with primary care: a cross-sectional study

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