Examination of disparity in access to mental health services among people living with HIV and comorbid depression in Ontario

Stephanie Choi, Eleanor Boyle, John Cairney, Adriana Carvalhal, Evan Collins, Murray D Krahn, Matthew Kumar, Paul Grootendorst, Sean B Rourke

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskningpeer review

Abstrakt

Depression is a common co-morbidity among people living with HIV. However, many HIV+ individuals are not diagnosed or not treated, resulting in poor HIV treatment outcomes and increased health care costs. We aimed to describe barriers and gaps in accessing mental health services among this high-need population in Ontario. A retrospective cohort study was conducted from 2008-2012 by linking the Ontario HIV Treatment Network (OHTN) Cohort Study (N=3,545) with administrative health databases in Ontario through the Institute of Clinical and Evaluative Sciences. Co-morbid depression was identified based on the Center for Epidemiologic Studies Depression Scale(Scores> ) or the Kessler Psychological Distress Scale(Scores>=23). The use of primary and specialty mental health services was measured during the 12 months followed by the assessment at the baseline. Logistic and Negative binominal regression models were constructed to examine associations between socio-demographics and the use and the intensity of the use of mental health services. 950(27%) HIV+ study participants were identified with co-morbid depression. Of these, 523(55%) and 444(47%) had at least one visit to the primary care and specialist care respectively during a year followed by the baseline. For those who were depressed, we found that non-English speakers were two times less likely (OR:0.48;95%CI:0.31-0.77) to use of primary mental health services and were having 37%(IRR:0.63;95%CI:0.42-0.98) fewer encounters when compared to their English speaking counterparts. For accessing specialist care, we found that those who were identified as homosexual/gay, non-English speakers, immigrants, having low income and residing in rural area were two times less likely to use these services. However, being a homosexual/gay, being an immigrant, and having low income were likely to have 30-50% fewer encounters to specialist care. Careful considerations of the impact of language barriers and cultural differences are important to address in delivering successful mental health care for this high-need population of people living with HIV in Ontario.
OriginalsprogEngelsk
Publikationsdato2014
StatusUdgivet - 2014
BegivenhedCanadian Association for Health Services and Policy Research Conference: Convergence of Health Policy and Evidence – Bridge Over Troubled Water - Toronto, Canada
Varighed: 12. maj 201415. maj 2014

Konference

KonferenceCanadian Association for Health Services and Policy Research Conference
LandCanada
ByToronto
Periode12/05/201415/05/2014

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