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Explaining service use for mental health problems in the Dutch general population: the role of resources, emotional disorder and functional impairment

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Abstract

Objective

To analyse explanations of service use in terms of resources, emotional (mood or anxiety) disorder and functional impairment.

Method

Data was derived from a prospective cohort study in a sample representative (n = 4848) of the Dutch adult general population.

Results

The occurrence of an emotional (mood or anxiety) disorder led to a greater use of services as a partial consequence of the functional impairments that accompanied the disorder, but this applied only to primary care services and not to specialised mental health services. After adjustment for the influence of all other determinants in the model, people with more education and those with higher neuroticism scores were more likely to use specialised services in particular.

Conclusions

Future research could benefit from applying the models derived here to further clarify the use of the two service modalities, as well as to assess additional psychological resources.

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Author information

Authors and Affiliations

  1. Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500, AS, Utrecht, The Netherlands

    Margreet ten Have & Wilma Vollebergh

  2. Social and Cultural Planning Office of the Netherlands, Den Haag, The Netherlands

    Jurjen Iedema

  3. Dept. of Psychiatry, University of Groningen, Groningen, The Netherlands

    Johan Ormel

Authors
  1. Margreet ten Have
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  2. Jurjen Iedema
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  3. Johan Ormel
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  4. Wilma Vollebergh
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Corresponding author

Correspondence to Margreet ten Have.

Appendix 1

Appendix 1

Results of structural equation modelling analyses on the conceptual explanatory model of service use for mental health problems. Model fit at each step

 

Step

Chi-Square

df

p

RMSEA

NNFI

Primary care only

Conceptual model

1

43.18

10

0.000

0.027

1.00

Paths deleted

    All paths associated with service use, except emotional disorder

2

130.73

16

0.000

0.039

1.00

Paths added

    Education → service use

3

92.19

15

0.000

0.033

1.00

    Neuroticism → service use

4

75.24

14

0.000

0.031

1.00

    Social role impairment → service use

5

58.97

13

0.000

0.028

1.00

    Emotional role impairment → service use

6

43.31

12

0.000

0.024

1.00

    Error variance between perceived social support and living alone (=basic model)

7

17.58

11

0.092

0.011

1.00

Specialised mental health care

Conceptual model

1

38.23

10

0.000

0.025

1.00

Paths deleted

    All paths associated with service use, except emotional disorder

2

356.06

16

0.000

0.070

1.00

Paths added

    Education → service use

3

69.76

15

0.000

0.029

1.00

    Neuroticism → service use

4

57.52

14

0.000

0.027

1.00

    Social role impairment → service use

5

45.78

13

0.000

0.024

1.00

    Error variance between perceived social support and living alone

6

31.27

12

0.002

0.019

1.00

    Neuroticism → social role impairment

7

23.16

11

0.017

0.016

1.00

    Neuroticism → emotional role impairment

8

10.49

10

0.398

0.003

1.00

Paths deleted

    Living alone → emotional disorder

9

11.65

11

0.390

0.004

1.00

    Social role impairment → service use (=basic model)

10

14.36

12

0.278

0.007

1.00

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Have, M.t., Iedema, J., Ormel, J. et al. Explaining service use for mental health problems in the Dutch general population: the role of resources, emotional disorder and functional impairment. Soc Psychiat Epidemiol 41, 285–293 (2006). https://doi.org/10.1007/s00127-005-0028-9

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  • DOI: https://doi.org/10.1007/s00127-005-0028-9

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