Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2013.54.444
Availability of mental health service providers and suicide rates in Slovenia: a nationwide ecological study
Helena Korošec Jagodič
; Psychiatric Hospital Vojnik, Vojnik, Slovenia
Tatjana Rokavec
; Institute of Public Health of the Republic of Slovenia, Ljubljana, Slovenia
Mark Agius
; South Essex Partnership University Foundation Trust, Weller Wing, Bedford Hospital, Bedford, UK
Peter Pregelj
; University Psychiatric Hospital Ljubljana, Ljubljana, Slovenia
Sažetak
Aim To investigate the influence of socioeconomic factors,
mental health service availability, and prevalence of mental
disorders on regional differences in the suicide rate in
Slovenia.
Methods The effects of different socioeconomic factors,
mental health service availability, and mental disorders factors
on suicide rates from 2000-2009 were analyzed using a
general linear mixed model (GLMM). Pearson correlations
were used to explore the direction and magnitude of associations.
Results Among socioeconomic factors, unemployment
rate ranked as the most powerful predictor of suicide and
an increase of one unit in the unemployment rate increased
regional suicide rate by 2.21 (β = 2.21, 95% confidence intervals
[CI] = 1.87-2.54, P < 0.001). On the other hand, higher
marriage/divorce ratio was negatively related to the suicide
rate and an increase of one unit in marriage/divorce
ratio reduced regional suicide rate by 1.16 (β = -1.16, 95%
CI = -2.20 to -0.13, P < 0.031). The most influential mental
health service availability parameter was higher psychiatrist
availability (4 psychiatrists and more working at outpatient
clinics per 100 000 inhabitants), which was negatively
correlated with the suicide rate and reduced regional suicide
rate by 2.95 (β = -2.95, 95% CI = -4.60 to -1.31, P = 0.002).
Another negatively correlated factor was the antidepressant/
anxiolytic ratio higher than 0.5, which reduced the regional
suicide rate by 2.32 (β = -2.32, 95% CI = -3.75 to -0.89,
P = 0.003). Among mental health disorders, only the prevalence
of alcohol use disorders was significantly related to
the regional suicide rates and an increase of one unit in the
prevalence of alcohol use disorders per 1000 inhabitants
increased the regional suicide rate by 0.02 (β = 0.02, 95%
CI = 0.01- 0.03, P = 0.008).
Conclusions Besides unemployment, which was a very
strong predictor of suicide rates, unequal availability of
mental health services and quality of depressive disorder
treatment may contribute to variations in suicide rates in
different regions.
Ključne riječi
Hrčak ID:
117009
URI
Datum izdavanja:
15.10.2013.
Posjeta: 1.292 *