Psychiatric services : a journal of the American Psychiatric Association
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Previous analyses demonstrated an elevated occurrence of perceived unmet need for mental health care among persons with co-occurring mental and substance use disorders in comparison with those with either disorder. This study built on previous work to examine these associations and underlying reasons in more detail. ⋯ The findings highlight potential problems for individuals with mental and substance use disorders in accessing services. The elevated occurrence of perceived unmet need appeared to be relatively less affected by contact with the health care system than by generalized distress and problem severity. Issues such as stigma, motivation, and satisfaction with past services may influence help-seeking patterns and perceptions of unmet need and should be examined in future work.
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As Iraq faces the challenge of securing a sustainable resolution to the current violence, the burden of mental illness is likely to increase dramatically. The impact of Saddam Hussein's dictatorship, the Iran-Iraq war, U. S.-led economic sanctions, the Persian Gulf wars, and the U. ⋯ Many multinational organizations, governments, and policy makers had the political will as well as the financial and human resources to greatly influence Iraq's mental health program. However, the lack of an existing mental health plan stifled these efforts. Applying Kingdon's model for policy development, which includes political analysis, problem defining, and proposal drafting, the authors describe the development of Iraq's current mental health policy.
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Randomized Controlled Trial Multicenter Study Comparative Study
Service use and outcomes among elderly persons with low incomes being treated for depression.
Older adults with low incomes rarely use mental health care, and untreated depression is a serious problem in this population. This study examined whether a collaborative care model for depression in primary care would increase use of depression treatment and treatment outcomes for low-income elderly adults as well as for higher-income older adults. ⋯ Lower-income older adults can experience benefits from collaborative management of depression in primary care similar to those of higher-income older adults, although they may require up to a year to reap physical health benefits.
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This study explored sociodemographic and mental health correlates of intensity of mental health care use in two large-scale surveys, aiming to discover the set of correlates with the greatest predictive capacity. ⋯ These findings extend research on correlates of mental health care use, addressing intensity of use, suggesting that sociodemographic factors and presence of a psychiatric disorder and associated disability drive the initial use of services, whereas presence of a psychiatric disorder and associated disability are associated with continued service use.