Zechmeister-Koss, I. and Tüchler, H. (2018): Prevalence of mental disorders and uptake of mental health services in Tyrol: An analysis of epidemiological literature and administrative data from the Tyrolean health insurance. HTA-Projektbericht 113b.
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Background and aim: Different approaches can be followed for the early identifying and supporting of children with mentally ill parents. One is to get into contact with the children via the parents in the adult mental health care settings. To explore this strategy further, information on the prevalence of both mental disorders and the usage of mental health benefits in Tyrol are analysed.
Method: Data on the prevalence of mental disorders in Tyrol are based on a review of published literature. For analysing the characteristics of mental health benefit uptake, administrative data from the Tyrolean health insurance (TGKK), which covers 80% of the Tyrolean population, are analysed using descriptive statistical analysis methods.
The administrative data cover benefits that are (co-)funded by the TGKK including: a) mental health services (hospital inpatient and day care, outpatient psychiatrist services, psychotherapy, inpatient rehabilitation, psychological services); b) medication and c) sick-leave due to a mental health problem.
Results: Robust epidemiological data for Tyrol are lacking. Based on mental health service uptake in 2011 it was estimated that 3% of the Austrian population suffers from severe mental disorder which would roughly affect 22,500 persons in Tyrol.
Overall, almost 86,000 TGKK-insured patients received at least one type of mental health benefit in 2017. This represents 14.5% of all insured. Five percent of patients were younger than 19 years, almost 60% were between 19 and 64 years old and the remainder was older than 64 years. Two third of recipients were females.
In patients who are potential parents of dependent children (age group 19-64 years old), the vast majority (80%) were prescribed medication and half of the patients received medication only. A quarter had contacted an outpatient psychiatrist and 13% received psychotherapy. Five percent were treated in psychiatric inpatient or day care. The most frequently occurring ICD-10 diagnoses were F1, F4 and F3. The median length of hospital stay was 15 days.
The overall number of benefit recipients has risen between 2012 and 2017; however the percentage of insured persons who received benefits remained almost stable. More persons had contact with outpatient psychiatrists, received psychotherapy or were on sick leave in 2017 compared to 2012, while those who received inpatient or day care decreased. The number of patients who were prescribed medication rose between 2012 and 1014 and has slightly decreased since then.
Discussion: While we know little on the prevalence of mental disorders in Tyrol, benefit uptake data show that 15% of the insured population received some TGKK-funded mental health benefit. In terms of frequency, medication plays the most important role, while services are utilised less often. The fact that most patients were prescribed medication means that most parents may be reached via general practitioners (almost 90% of psychotropic drugs are prescribed by general practitioners). In contrast, only 5% may be reached on a psychiatric hospital ward. The latter are, however, the most severely ill who may have a greater need for support for themselves and their children.
Limitations of the study are that the data cover only a part of all mental health services available in Tyrol (e.g. information on hospital outpatient care or psychosocial services is lacking) and only 80% of the population. The analysis does not allow conclusions on the prevalence of mental disorders because many people with mental health problems do not seek professional support in mental health care. Administrative data have some limitations regarding the validity of the information on diagnoses.
Conclusion: The proportion of mentally ill parents that one may be able to reach via adult mental health care differs considerably according to the setting chosen. Additionally, severity and type of illness differ by setting. Each setting involves different organisational challenges for implementing and evaluating support. Administrative data are a useful piece of information for assisting planning but cannot replace robust epidemiological data.
|Item Type:||Project Report|
|Keywords:||Mental illness, benefit uptake, mental health care, administrative data|
|Subjects:||WA Public health > WA 525-590 Health administration and organisation|
WA Public health > WA 308 Family health
WM Psychiatry > WM 140 Mental disorders
WA Public health > WA 105 Epidemiology
QV Pharmacology, toxicology, pharmacy > QV 77 Psychopharmacology
|Series Name:||HTA-Projektbericht 113b|
|Deposited on:||08 Nov 2018 16:45|
|Last Modified:||14 Mar 2019 15:02|
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