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Table 2 Barriers and facilitators to mental healthcare access in the 4.5 years before a NCRMD offense

From: Barriers and facilitators of access and utilization of mental health services among forensic service users along the care pathway

Variables

Seeking mental health care

(N = 753)

Reaching psychiatric care (N = 661)

Receiving: Volume of psychiatric care

(N = 555)

Receiving: Continuity of psychiatric care

(N = 437)

Volume of emergency mental healthcare (N = 661)

OR

95% CI

OR

95% CI

RR

95% CI

β

95% CI

RR

95% CI

Block 1: Contextual

 Physicians per 1000 pop.

1.16

0.64, 2.09

1.84

1.15, 2.85

1.31

1.02, 1.67

0.07

−0.14, 0.27

1.20

0.91, 1.59

 Residency outside of major urban centres

1.36

0.55, 3.35

2.61

1.20, 5.66

0.78

0.52, 1.19

0.13

−0.25, 0.52

2.06

1.40, 3.02

 Material disadvantage of residency area

0.84

0.70, 1.00

0.93

0.78, 1.10

0.95

0.87, 1.04

−0.00

−0.08, 0.07

0.91

0.83, 1.00

 Social disadvantage of residency area

1.12

0.95, 1.34

0.92

0.78, 1.08

1.03

0.95, 1.12

0.07

−0.01, 0.13

0.98

0.87, 1.11

 Community ressources within 15 min.

1.00

1.00, 1.00

1.00

1.00, 1.00

1.00

1.00, 1.00

−0.00

−0.00, 0.00

1.00

1.00, 1.00

 Hospital centres offering outreach services within 30 min.

1.00

0.74, 1.35

1.31

0.99, 1.71

0.86

0.75, 0.98

0.18

0.01, 0.36

1.01

0.87, 1.17

 Hospital centres offering referral services within 60 min.

1.00

0.92, 1.08

1.11

1.04, 1.18

0.99

0.96, 1.02

−0.02

−0.05, 0.01

1.02

0.99, 1.06

Block 2: Predisposing

 Age

0.99

0.97, 1.02

0.98

0.96, 1.00

0.99

0.98, 1.00

−0.01

−0.02, − 0.00

0.98

0.98, 0.99

 Female gender

1.56

0.65, 3.71

1.39

0.77, 2.53

1.10

0.77, 1.56

0.04

−0.23, 0.32

1.67

1.13, 2.48

 Living with a partner, family or friends

0.53

0.33, 0.87

0.64

0.83, 1.06

0.73

0.59, 0.91

0.04

−0.17, 0.25

0.89

0.69, 1.16

 Criminal history

2.20

1.29, 3.75

1.15

0.73, 1.81

1.06

0.86, 1.31

−0.07

−0.27, 0.11

1.29

1.01, 1.64

 General practitioner connection

3.58

1.75, 7.36

0.87

0.52, 1.45

0.82

0.65, 1.04

0.19

−0.06, 0.43

0.95

0.71, 1.26

Block 3: Need

 NCR history

2.30

0.65, 8.13

16.3

2.16, 123.0

1.86

1.43, 2.41

0.13

−0.15, 0.40

1.77

1.08, 2.90

 Psychotic disorder

1.56

0.66, 3.71

2.29

1.12, 4.68

1.71

1.07, 2.75

0.21

−0.19, 0.62

0.71

0.44, 1.14

 Mood disorder

1.45

0.57, 3.65

1.86

0.88, 3.97

1.45

0.88, 2.38

0.06

−0.35, 0.48

0.65

0.41, 1.06

 Other disorders

1.32

0.59, 2.96

0.70

0.35, 1.39

1.24

0.87, 1.77

0.26

−0.26, 0.79

0.77

0.54, 1.08

 Concurrent personality disorder

0.76

0.35, 1.65

2.24

0.87, 5.71

1.02

0.77, 1.36

−0.13

−0.41, 0.15

1.31

0.95, 1.81

 Concurrent substance use disorder

1.39

0.81, 2.37

2.53

1.39, 4.60

0.85

0.68, 1.07

0.26

0.00, 0.52

1.31

1.04, 1.66

  1. Exact p-values of statistically significant variables (bolded) are provided in text. Seeking care: At least one contact with any medical services for mental health reasons. Reaching psychiatric care: At least one contact with a psychiatrist. The model for seeking care used the full sample (n = 753), whereas the models for reaching care and volume of emergency care included those who had sought care (n = 661). The model for receiving – volume of psychiatric care included all those who had reached psychiatric care (n = 555) whereas the model for receiving – continuity of psychiatric care included only those with at least two psychiatric visits (n = 437)
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BMC Health Services Research

ISSN: 1472-6963

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