Predictors of incident care service utilisation for mental health problemsin the Dutch general population

Background: The determinants of first-time ('incident') use of primary care and mental health care services for mental health problems have not been p reviously investigated. Such information is needed to identify new client g roups and to gain a better understanding of causal factors. Method: Data we re derived from the Netherlands Mental Health Survey and Incidence Study, N EMESIS, a prospective general population study of adults. Potential predict ors of care use (psychiatric disorders, burden of illness, sociodemographic characteristics) were recorded in the first wave of the study, and the uti lisation of care services in the second wave. Psychiatric diagnoses were ba sed on the Composite International Diagnostic Interview (CIDI) 1.1. Results : Six of the ten indicators linked to the frequent utilisation of care were found not to be associated with incident use: higher age, lower income, li ving alone, paid employment, mood disorders and anxiety disorders. Four oth er indicators showed associations with both frequent and incident use: fema le gender, higher numbers of restricted activity days, poorer social functi oning and unmet care needs. Two predictors of incident use only were lower educational attainment and being in treatment for a somatic disorder. Concl usion: New clients who come to primary health care or mental health care se rvices with mental health problems are found in all age groups. They are mo re likely to be women, to have less education, to be in treatment for a som atic disorder and to have functional problems related to their mental healt h problems.