Preferences of help regarding behavioral health problems among the Japanese general population

Authors


THE JAPANESE HEALTH-CARE system is a free-access system: patients are allowed to see any doctor in any subspecialty. Therefore, an understanding of why and where people seek care for behavioral disorders is important for planning for the behavioral health-services system.1,2 This study was undertaken to investigate where people would seek help when they were presented with typical behavioral problem scenarios.

Of 192 000 individuals who registered as survey participants in a Japanese online research survey website, survey questionnaires were distributed to those who agreed to participate in this study.

Eight case vignettes (available upon request) were presented in the questionnaire. In each case, the same question was asked regarding a consultation provider. Subjects were asked to rate how acceptable each consultation provider would be, scoring on a scale from 1 (‘definitely not acceptable’) to 4 (‘definitely acceptable’). This study was approved by the Institutional Review Board of Saitama Medical University, Saitama Medical Center.

A total of 1085 general people returned the questionnaire (male sex, 49.7%, mean age, 46.2 years). Table 1 shows the percentage of responders who rated a consultation provider as ‘definitely acceptable’ for each mental disorder. The participants reported a psychiatric clinic in a general hospital and a standalone psychiatric clinic to be the desirable type of provider to address many behavioral health problems. Although the welfare offices and mental health helpline could play appropriate gate-keeping roles, the general population did not consider these options as desirable providers for consultation. The family doctor was recognized as a relatively desirable provider for many behavioral health problems, especially mild cognitive impairment and dementia. It is essential that an efficient and effective collaboration system between psychiatrists and family physicians is organized.3

Table 1. Percentage of responders who rated a consultation provider as ‘definitely acceptable’ for each mental disorder (%)
Mental disorderConsultation provider
PoliceWelfare officesMental health helplineFamily doctorStandalone medical clinicStandalone psychiatric clinic
Schizophrenia0.08.010.912.04.765.6
Depression0.06.213.611.14.155.2
Depression with cancer0.17.611.426.510.936.5
Mild cognitive impairment0.17.03.824.46.913.3
Dementia4.614.73.924.79.022.7
Panic disorder0.24.15.725.917.347.1
Alcohol dependence0.212.27.428.818.838.5
Psychosis due to a general medical condition0.97.66.824.914.651.1
Mental disorderConsultation provider
Medical clinic in a general hospitalPsychiatric clinic in a general hospitalPsychiatric hospitalNursing homeOther
Schizophrenia3.254.247.70.80.6
Depression5.349.637.70.41.5
Depression with cancer15.137.020.24.51.9
Mild cognitive impairment11.315.29.411.62.6
Dementia12.824.519.443.11.4
Panic disorder22.849.426.60.62.2
Alcohol dependence22.242.029.30.91.4
Psychosis due to a general medical condition19.453.540.61.31.3

It is important to know the preference of the general population in behavioral health care and reflect this opinion in behavioral health-care policy.1,2

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