Factors affecting the referral rate of the hoarding disorder at primary mental health care in Quebec

Journal article citation:
Community Mental Health Journal, 54(6), 2018, pp.773-781.

Hoarding disorder (HD) places an important burden on people with HD, on their family members and society. This paper evaluates help-seeking in HD at primary mental health, measured in referral rate, together with its individual, environmental and structural correlates. The authors conducted an aggregate study by combining existing official data with their own survey data at the catchment area level. The authors found a mean annual referral rate of 1.58 (SD = 1.79) cases of HD in primary mental health facilities per 10,000 of adult population. The referrals rate correlated with socio-demographic characteristics of the catchment area, the availability of tools for clinical management of HD, and affiliation to a University Medical school. They also found that: (1) family members, neighbours, municipal workers and health professionals are the primary source of complaints for HD; (2) 72% of primary mental health facilities worked with HD in crisis situations, 52% expressed difficulties in obtaining the consent of people with HD for an intervention (3) health/social services professionals lack HD clinical management tools, training and formal collaboration with municipal (housing, building security, fire prevention) specialists. Improvement of the readiness of the health-system to deal with HD will improve help-seeking for formal medical counselling on the part of people with HD. The authors argue this readiness could be improved by providing primary mental-health facilities with training, clinical management tools and by helping them to establish formal collaboration with municipalities and community organisations. University medical schools can take a leadership role and become centres catalysing the change in HD clinical management. (Edited publisher abstract)

Subject terms:
referral, primary care, mental health problems, service uptake, housing conditions, community mental health services;
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