Factors associated with a 12-month subsequent mental health service use*
| Variable | From GP OR (95% CI) | From psychiatrist OR (95% CI) | From any healthcare professional† OR (95% CI) |
|---|---|---|---|
| Gender (female) | |||
| Male | 0.58 (0.15 to 2.21) | 1.44 (0.51 to 4.02) | 2.35 (0.92 to 6.05) |
| Age group (18–34 years) | |||
| 35–54 years | 0.41 (0.08 to 2.25) | 0.88 (0.22 to 3.55) | 0.77 (0.22 to 2.63) |
| 55 years and above | 1.31 (0.22 to 7.67) | 1.26 (0.27 to 5.85) | 1.39 (0.34 to 5.72) |
| Education (secondary and above) | |||
| Primary or no formal education | 0.21 (0.04 to 1.11) | 0.60 (0.19 to 1.83) | 0.44 (0.14 to 1.36) |
| Marital status (married) | |||
| All others‡ | 0.55 (0.15 to 1.99) | 1.00 (0.36 to 2.76) | 0.91 (0.35 to 2.36) |
| Employment status (employed) | |||
| All others§ | 0.88 (0.26 to 2.97) | 0.88 (0.31 to 2.46) | 0.80 (0.30 to 2.11) |
| Household monthly family income (≤HK$ 30 000) | |||
| >HK$ 30 000 | 0.76 (0.18 to 3.18) | 0.65 (0.18 to 2.36) | 0.50 (0.16 to 1.56) |
| District of residence (Hong Kong island) | |||
| Kowloon | 0.40 (0.10 to 1.63) | 0.93 (0.26 to 3.27) | 2.17 (0.68 to 6.95) |
| New Territories and Outlying Islands | 0.07 (0.01 to 0.62)¶ | 2.36 (0.78 to 7.14) | 1.65 (0.59 to 4.57) |
| Physical comorbidities (none) | |||
| At least one | 0.58 (0.14 to 2.46) | 1.06 (0.32 to 3.54) | 0.51 (0.17 to 1.55) |
| Family history of mental illness (no) | |||
| Yes | 1.18 (0.30 to 4.59) | 0.93 (0.28 to 3.15) | 0.91 (0.27 to 3.05) |
| Self-reported diagnosed depression (no) | |||
| Yes | 10.88 (2.96 to 40.01)¶ | 8.86 (3.38 to 23.22)¶ | 17.86 (6.63 to 48.12)¶ |
| Self-reported diagnosed other mental illness (no) | |||
| Yes | 7.35 (1.50 to 35.99)¶ | 7.08 (2.05 to 24.50)¶ | 18.99 (4.66 to 77.49)¶ |
| Presence of professional help-seeking intention (none) | |||
| At least one | 3.42 (0.98 to 11.93) | 1.13 (0.44 to 2.89) | 1.80 (0.74 to 4.39) |
| Presence of a past help-seeking action (none) | |||
| At least one | 1.37 (0.37 to 5.04) | 2.84 (0.96 to 8.41) | 2.83 (1.07 to 7.53)¶ |
| Doctor diagnosis of depression at baseline (no) | |||
| Yes | 1.26 (0.41 to 3.90) | 4.02 (1.52 to 10.62)¶ | 2.85 (1.08 to 7.49)¶ |
| PHQ-9 severity at baseline (mild-moderate) | |||
| Moderately severe to severe depression** | 2.18 (0.72 to 6.61) | 1.28 (0.52 to 3.14) | 1.83 (0.76 to 4.39) |
| Service sector (private) | |||
| Public | 1.49 (0.44 to 5.07) | 7.25 (2.34 to 22.48)¶ | 4.21 (1.45 to 12.20)¶ |
Brackets indicate reference categories.
Hosmer and Lemeshow tests suggested an adequate model fit for all three models. For the GP model, χ2=10.269, p=0.247; psychiatrist, χ2=6.369, p=0.606; any professional, χ2=7.691, p=0.464.
*Respondents included PHQ screened-positive participants who entered the cohort study.
†Includes a GP, psychiatrist, psychologist, social worker and other professional.
‡‘All others’ in marital status includes being single, divorced or widow.
§‘All others’ in employment status includes being unemployed, retired, house-maker or student.
¶Statistically significant at p<0.05.
**PHQ-9 score: 10–14=mild to moderate depression; 15–27=moderately severe to severe depression.
GP, general practitioner; PHQ, Patient Health Questionnaire.