Abstract

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Background
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?

Background

Survey data and provincial administrative health data are the major sources of population estimates of mental health care visits to General Practitioners (GPs).  Previous research has suggested that self-reported estimates of the number of mental health-related visits per person to health professionals may exceed estimates obtained from physician reimbursement records.

Data and methods

Self-reported data from the 2002 Canadian Community Health Survey (CCHS): Mental Health and Well-being and administrative records from the Medical Services Plan of British Columbia were linked.  The analytic sample consisted of 145 CCHS respondents who had at least one mental health visit to a GP in the past 12 months according to both data sources.  High Reporters (self-reported visits exceeded number in administrative data), Low Reporters (self-reported visits were less than number in administrative data), and Exact Matches were analyzed in two ways.  The first analysis used diagnostic codes to identify mental health-related visits in the administrative data.  For the second analysis, all GP visits in the administrative data were counted as "possibly" mental health-related.  Differences were described based on the median number of visits.

Results

When diagnostic codes were used to identify mental-health-related visitis in the administrative data, High Reporters (49%) substantially exceeded Low Reporters (24%).  The remaining 27% were Exact Matches.  Based on a broader definition of a mental health visit, 51% were Exact Matches.  High reporting was common among people with mental disorders.  

Interpretation

Self-reported data and administrative data provide different estimates of the number of mental health visits per person to GPs.  The discrepancy can be large.

Keywords

databases, data collection, data interpretation, health surveys, medical record linkage, mental disorders, mental health services

Findings

General practitioners (GPs) are the main source of mental health care for most Canadians. Information about the number of times individuals talk with GPs about mental health concerns is used for a variety of purposes, such as assessing adherence to treatment follow-up guidelines. The major sources of population-level data on primary mental health care visits are surveys, particularly the 2002 Canadian Community Health Survey: Mental Health and Well-being (CCHS 1.2), and provincial administrative health records, which the Public Health Agency of Canada now uses for national surveillance of "treated" mental health issues. Yet evidence from two previous studies indicates that survey data provide higher within-individual estimates of the number of mental health visits than do provincial administrative data. [Full Text]

Authors

JoAnne L. Palin (1-250-816-5050; joanne.ubc@gmail.com), Mieke Koehoorn, and Clyde Hertzman are with the School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3.  Elliot M. Goldner is with the Centre for Applied Research in Mental Health and Addiction, Simon Fraser University, Vancouver, British Columbia.