Trends in Primary Mental Health Care Service Use and Subsequent Self-Harm in Western Sydney Australia: Policy and Workforce Implications

Sithum Munasinghe, Andrew Page, Sandro Sperandei, Pankaj Gaur, Shahana Ferdousi, Haider Mannan and Vlasios Brakoulias
Additional contact information
Sithum Munasinghe: Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
Andrew Page: Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
Sandro Sperandei: Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
Pankaj Gaur: Western Sydney Local Health District, Integrated and Community Health Department, 5 Fleet Street, North Parramatta, NSW 2151, Australia
Shahana Ferdousi: Western Sydney Primary Health Network, Level 1/85 Flushcombe Road, Blacktown, NSW 2148, Australia
Haider Mannan: Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
Vlasios Brakoulias: Translational Health Research Institute, Campbelltown Campus, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia

IJERPH, 2022, vol. 19, issue 6, 1-12

Abstract: Background: This study investigated the trends in primary mental health care (PMHC) service use and hospital-treated self-harm in Western Sydney (Australia). Methods: A data linkage study and descriptive ecological study of PMHC referrals investigated the trends in referrals, treatment attendance, hospital-treated self-harm, and health care practitioners (HCPs) for the period of 2013−2018 ( n = 19,437). Results: There was a substantial increase in referrals from 2016. The majority of referrals were females (60.9%), those aged <45 years (71.3%), and those presenting with anxiety or affective disorders (78.9%). Referrals of those at risk of suicide increased from 9.7% in 2013 to 17.8% in 2018. There were 264 (2.2%) cases of subsequent hospital-treated self-harm, with higher rates among those at risk of suicide and those who attended <6 sessions. The number of HCPs per referral also increased from 2013, as did waiting times for treatment initiation. Conclusion: Individuals presenting to PMHC services at risk of suicide, and who subsequently presented to a hospital setting following self-harm, were more likely to either not attend services following a referral or to attend fewer services. This trend occurred in the context of an increase in the number of clients per HCP, suggesting workforce capacity has not kept pace with demand.

Keywords: primary mental health care; psychological treatments; self-injurious behavior; mental health policy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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