Where do primary care patients go for mental health care in Hong Kong?

Abstract

INTRODUCTION The objective of this study was to examine the mental health help-seeking behaviors and preferences among primary care patients and to investigate the socio-demographic and health status factors that predict help-seeking from a primary care physician (PCP). METHOD A cross-sectional survey was conducted on waiting room patients in 59 primary care clinics in public and private settings across Hong Kong. The questionnaire contained the Patient Health Questionnaire-9 and items on socio-demography, previous help-seeking behaviors and help-seeking preferences for depression and mental health. RESULTS 10,179 patients were surveyed with an 81% response rate. When asked who they would seek help from if they were depressed, patients expressed a preference for friends and family (49.1%) over a psychiatrist (26.1%) or PCP (20.1%). Overall men and older patients were less likely to seek help. In terms of professional help, a psychiatrist is more preferred by males while a psychologist or PCP is more preferred by females. In patients with PHQ-9 scores >9, 7.4% had sought the help of a psychiatrist, 4.1% a psychologist and 9.5% a PCP. Patients most likely to seek help from a PCP were female, older, had co-existing illnesses and had milder symptoms of depression. DISCUSSION Approximately a quarter of primary care patients with screened-positive depression reported to have sought professional help for mental health, with more receiving help from a psychiatrist and/or psychologist than a PCP. This has implications for service planning and delivery.