Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic

Objective:The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic s...

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Veröffentlicht in:Psychiatric services (Washington, D.C.) D.C.), 2023-06, Vol.74 (6), p.581-588
Hauptverfasser: Gao, Caroline X., McDonald, Lachlan P., Hamilton, Matthew P., Simons, Koen, Menssink, Jana M., Filia, Kate, Rickwood, Debra, Rice, Simon, Hickie, Ian, McGorry, Patrick D., Cotton, Sue M.
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container_end_page 588
container_issue 6
container_start_page 581
container_title Psychiatric services (Washington, D.C.)
container_volume 74
creator Gao, Caroline X.
McDonald, Lachlan P.
Hamilton, Matthew P.
Simons, Koen
Menssink, Jana M.
Filia, Kate
Rickwood, Debra
Rice, Simon
Hickie, Ian
McGorry, Patrick D.
Cotton, Sue M.
description Objective:The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic status, and residence in particular geographical areas.Methods:Interrupted time-series analyses were conducted by using quarterly mental health MBS service data (all young people ages 12–25 years, 2015–2020) for individual Statistical Area Level 3 areas across Australia. The data captured >22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates.Results:Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%–7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18–25. A decreasing trend was observed for males ages 18–25 (3.5% reduction, 95% CI=2.5%–4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status.Conclusions:During 2020, young people’s use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds.
doi_str_mv 10.1176/appi.ps.20220345
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The data captured &gt;22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates.Results:Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%–7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18–25. A decreasing trend was observed for males ages 18–25 (3.5% reduction, 95% CI=2.5%–4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status.Conclusions:During 2020, young people’s use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds.</description><identifier>ISSN: 1075-2730</identifier><identifier>EISSN: 1557-9700</identifier><identifier>DOI: 10.1176/appi.ps.20220345</identifier><identifier>PMID: 36444529</identifier><language>eng</language><publisher>United States: American Psychiatric Association</publisher><subject>Adolescent ; Adult ; Aged ; Australia - epidemiology ; COVID-19 ; COVID-19 - epidemiology ; Female ; Health care access ; Health Services Accessibility ; Healthcare Disparities ; Humans ; Male ; Mental Disorders - epidemiology ; Mental Disorders - therapy ; Mental Health ; Mental health care ; National Health Programs ; Pandemics ; Young Adult ; Young adults</subject><ispartof>Psychiatric services (Washington, D.C.), 2023-06, Vol.74 (6), p.581-588</ispartof><rights>Copyright © 2023 by the American Psychiatric Association 2023</rights><rights>Copyright American Psychiatric Publishing, Inc. Jun 2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a365t-6f28b6f69dece46c773cfb6e0f78b8a022cbe4de73de0aae6af575a2494357d23</citedby><cites>FETCH-LOGICAL-a365t-6f28b6f69dece46c773cfb6e0f78b8a022cbe4de73de0aae6af575a2494357d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/appi.ps.20220345$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/appi.ps.20220345$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>315,781,785,2856,21631,21632,21633,27929,27930,77799,77804</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36444529$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gao, Caroline X.</creatorcontrib><creatorcontrib>McDonald, Lachlan P.</creatorcontrib><creatorcontrib>Hamilton, Matthew P.</creatorcontrib><creatorcontrib>Simons, Koen</creatorcontrib><creatorcontrib>Menssink, Jana M.</creatorcontrib><creatorcontrib>Filia, Kate</creatorcontrib><creatorcontrib>Rickwood, Debra</creatorcontrib><creatorcontrib>Rice, Simon</creatorcontrib><creatorcontrib>Hickie, Ian</creatorcontrib><creatorcontrib>McGorry, Patrick D.</creatorcontrib><creatorcontrib>Cotton, Sue M.</creatorcontrib><title>Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic</title><title>Psychiatric services (Washington, D.C.)</title><addtitle>Psychiatr Serv</addtitle><description>Objective:The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic status, and residence in particular geographical areas.Methods:Interrupted time-series analyses were conducted by using quarterly mental health MBS service data (all young people ages 12–25 years, 2015–2020) for individual Statistical Area Level 3 areas across Australia. The data captured &gt;22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates.Results:Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%–7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18–25. A decreasing trend was observed for males ages 18–25 (3.5% reduction, 95% CI=2.5%–4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status.Conclusions:During 2020, young people’s use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Australia - epidemiology</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>Female</subject><subject>Health care access</subject><subject>Health Services Accessibility</subject><subject>Healthcare Disparities</subject><subject>Humans</subject><subject>Male</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - therapy</subject><subject>Mental Health</subject><subject>Mental health care</subject><subject>National Health Programs</subject><subject>Pandemics</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1075-2730</issn><issn>1557-9700</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kTtPwzAURi0E4r0zIUssLCl-OxmrlkclEAyAxBQ5zg0NygvbGfj3uLR0QGKyZZ3z-dofQmeUTCjV6soMQz0Z_IQRxggXcgcdUil1kmlCduOeaJkwzckBOvL-gxBCNVX76IArIYRk2SGyiw4-R9PUoQaP6w5PrQXvcejxA3TBNPgOTBOW-NmBCW08wsUXno4-uCiZDr_1Y1h6PB9d3b3jsAQ8e3xdzBOa4SfTldDW9gTtVabxcLpZj9HLzfXz7C65f7xdzKb3ieFKhkRVLC1UpbISLAhltea2KhSQSqdFauITbQGiBM1LIMaAMpXU0jCRCS51yfgxulznDq7_HMGHvK29haYxHfSjz5kWTEnFGY_oxR_0ox9dF6fLWcpoprSSaaTImrKu995BlQ-ubo37yinJVwXkqwLyIUqbAqJyvgkeixbKrfD74xFI1sCPur3138BvizyQng</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Gao, Caroline X.</creator><creator>McDonald, Lachlan P.</creator><creator>Hamilton, Matthew P.</creator><creator>Simons, Koen</creator><creator>Menssink, Jana M.</creator><creator>Filia, Kate</creator><creator>Rickwood, Debra</creator><creator>Rice, Simon</creator><creator>Hickie, Ian</creator><creator>McGorry, Patrick D.</creator><creator>Cotton, Sue M.</creator><general>American Psychiatric Association</general><general>American Psychiatric Publishing, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20230601</creationdate><title>Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic</title><author>Gao, Caroline X. ; McDonald, Lachlan P. ; Hamilton, Matthew P. ; Simons, Koen ; Menssink, Jana M. ; Filia, Kate ; Rickwood, Debra ; Rice, Simon ; Hickie, Ian ; McGorry, Patrick D. ; Cotton, Sue M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a365t-6f28b6f69dece46c773cfb6e0f78b8a022cbe4de73de0aae6af575a2494357d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Australia - epidemiology</topic><topic>COVID-19</topic><topic>COVID-19 - epidemiology</topic><topic>Female</topic><topic>Health care access</topic><topic>Health Services Accessibility</topic><topic>Healthcare Disparities</topic><topic>Humans</topic><topic>Male</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Disorders - therapy</topic><topic>Mental Health</topic><topic>Mental health care</topic><topic>National Health Programs</topic><topic>Pandemics</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gao, Caroline X.</creatorcontrib><creatorcontrib>McDonald, Lachlan P.</creatorcontrib><creatorcontrib>Hamilton, Matthew P.</creatorcontrib><creatorcontrib>Simons, Koen</creatorcontrib><creatorcontrib>Menssink, Jana M.</creatorcontrib><creatorcontrib>Filia, Kate</creatorcontrib><creatorcontrib>Rickwood, Debra</creatorcontrib><creatorcontrib>Rice, Simon</creatorcontrib><creatorcontrib>Hickie, Ian</creatorcontrib><creatorcontrib>McGorry, Patrick D.</creatorcontrib><creatorcontrib>Cotton, Sue M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Psychiatric services (Washington, D.C.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gao, Caroline X.</au><au>McDonald, Lachlan P.</au><au>Hamilton, Matthew P.</au><au>Simons, Koen</au><au>Menssink, Jana M.</au><au>Filia, Kate</au><au>Rickwood, Debra</au><au>Rice, Simon</au><au>Hickie, Ian</au><au>McGorry, Patrick D.</au><au>Cotton, Sue M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic</atitle><jtitle>Psychiatric services (Washington, D.C.)</jtitle><addtitle>Psychiatr Serv</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>74</volume><issue>6</issue><spage>581</spage><epage>588</epage><pages>581-588</pages><issn>1075-2730</issn><eissn>1557-9700</eissn><abstract>Objective:The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic status, and residence in particular geographical areas.Methods:Interrupted time-series analyses were conducted by using quarterly mental health MBS service data (all young people ages 12–25 years, 2015–2020) for individual Statistical Area Level 3 areas across Australia. The data captured &gt;22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates.Results:Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%–7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18–25. A decreasing trend was observed for males ages 18–25 (3.5% reduction, 95% CI=2.5%–4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status.Conclusions:During 2020, young people’s use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds.</abstract><cop>United States</cop><pub>American Psychiatric Association</pub><pmid>36444529</pmid><doi>10.1176/appi.ps.20220345</doi><tpages>8</tpages></addata></record>
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subjects Adolescent
Adult
Aged
Australia - epidemiology
COVID-19
COVID-19 - epidemiology
Female
Health care access
Health Services Accessibility
Healthcare Disparities
Humans
Male
Mental Disorders - epidemiology
Mental Disorders - therapy
Mental Health
Mental health care
National Health Programs
Pandemics
Young Adult
Young adults
title Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic
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