Influence of perceived and evaluated individual characteristics on mental health services utilization of patients with depressive disorders - a longidudinal study to supplement the Behavioral Model of Health Services Use and to explore adaquacy of health services use

• Applicant: Privatdozentin Dr. Anna Levke Brütt
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2014 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 271518504

Just about every third person in Germany who meets the diagnostic criteria for depression has contact to mental health care. The reasons for using mental health services are described in theoretical models such as the "Behavioural Model of Health Services Use". In contrast to models explaining health behaviour change, the patient's perspective has rarely been included in the “Behavioural Model of Health Services Use”. As established characteristics cannot sufficiently explain mental health services use, perceived and evaluated individual characteristics such as illness and treatment beliefs as well as subjective need should be integrated into the model. The aim of the proposed study is to integrate the subjective characteristics in the "Behavioural Model of Health Services Use" and to investigate whether these improve prediction of health services use in persons with depression. Additionally, a focus lies on persons who incongruently to objective or subjective need, use or not use depression-specific health services. The percentage of those persons will be described. Finally, explanations of the incongruity in health services use will be studied. A prospective, longitudinal and locally representative survey will be conducted. Additional qualitative interviews will be used to explain quantitative data. At t0 and 12 months later (t1), established and subjective characteristics will be quantitatively collected via telephone interviews. Moreover, standardized diagnostic interviews for mental disorders will be conducted. Additionally, up to 32 persons will be selected for qualitative interviews and questioned about reasons for their use of mental health services. Besides descriptive and regression analysis, a grounded theory based analysis will be used to explore theories regarding incongruent health services use. The results of the proposed study are relevant regarding the theoretical foundation of health services research. They can be used to complement the "Behavioural Model of Service Use" and to empirically validate the model. Additionally, the perspective of patients will offer insights into incongruent health services use. Furthermore, the results regarding health services use can be used to create patient-centered health services: Changeable predictors of health services use are starting points for strategies to increase health services use congruent to objective and subjective needs of persons with depression.

• DFG Programme: Research Grants