TY - JOUR
T1 - Analysis of the barriers of mental distress disclosure in medical inpatients in Taiwan
AU - Han, Der Yan
AU - Lin, Yi Yin
AU - Liao, Shih Cheng
AU - Lee, Ming Been
AU - Thornicroft, Graham
AU - Wu, Chia Yi
PY - 2015/8/28
Y1 - 2015/8/28
N2 - Background: Disclosure of mental distress to physicians is important for mental illness identification, early referrals and proper treatment to prevent suicide. Little is known about what affects mental health communication in the clinical settings in the Chinese societies. Aims: The study aimed to identify the demographic, psychosocial and medical factors related to people with nondisclosure of their mental distress. Methods: We interviewed a series of consecutive inpatients from two medical wards of a general hospital in northern Taiwan. We collected depressive symptoms (the Patient Health Questionnaire, PHQ-9), living arrangement, threatening life events, suicide risks (i.e. past self-harm history, lifetime suicide ideas and hopelessness) and recent experience of mental distress disclosure. Furthermore, we explored the reasons of non-disclosure. Results: A total of 230 medical inpatients agreed to participate (53.5% males). The results indicated that only 5.7% actually communicated their mental health concerns, and that 12.3% were willing to talk about their mental health problems. Among the 69 (30%) depressed participants (PHQ-9 score ≥ 10 points), the disclosure rate was low (8.7%) and the wish to talk about mental distress was also low (10.3%). After adjustment, living alone (OR = 7.58, 95% CI = 1.5636.91) and having stressful life events (OR = 3.68, 95% CI = 1.0912.46) remained significant in predicting disclosure of mental distress. The 109 participants attributed their refusal of communicating mental distress as medical-related attributes, subjective perceptions or sociocultural factors. Conclusion: Communication of mental distress in medical settings was uncommon due to medical or psychosocial barriers in Taiwan. Skill training to facilitate disclosure in medical education and public campaigns to improve knowledge of depression and enhance help-seeking deserve more attention, particularly under the influence of stigma in the Chinese societies.
AB - Background: Disclosure of mental distress to physicians is important for mental illness identification, early referrals and proper treatment to prevent suicide. Little is known about what affects mental health communication in the clinical settings in the Chinese societies. Aims: The study aimed to identify the demographic, psychosocial and medical factors related to people with nondisclosure of their mental distress. Methods: We interviewed a series of consecutive inpatients from two medical wards of a general hospital in northern Taiwan. We collected depressive symptoms (the Patient Health Questionnaire, PHQ-9), living arrangement, threatening life events, suicide risks (i.e. past self-harm history, lifetime suicide ideas and hopelessness) and recent experience of mental distress disclosure. Furthermore, we explored the reasons of non-disclosure. Results: A total of 230 medical inpatients agreed to participate (53.5% males). The results indicated that only 5.7% actually communicated their mental health concerns, and that 12.3% were willing to talk about their mental health problems. Among the 69 (30%) depressed participants (PHQ-9 score ≥ 10 points), the disclosure rate was low (8.7%) and the wish to talk about mental distress was also low (10.3%). After adjustment, living alone (OR = 7.58, 95% CI = 1.5636.91) and having stressful life events (OR = 3.68, 95% CI = 1.0912.46) remained significant in predicting disclosure of mental distress. The 109 participants attributed their refusal of communicating mental distress as medical-related attributes, subjective perceptions or sociocultural factors. Conclusion: Communication of mental distress in medical settings was uncommon due to medical or psychosocial barriers in Taiwan. Skill training to facilitate disclosure in medical education and public campaigns to improve knowledge of depression and enhance help-seeking deserve more attention, particularly under the influence of stigma in the Chinese societies.
KW - Barriers
KW - mental distress disclosure
KW - suicide prevention
KW - Taiwan
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U2 - 10.1177/0020764014552865
DO - 10.1177/0020764014552865
M3 - Article
C2 - 25303956
AN - SCOPUS:84937884678
SN - 0020-7640
VL - 61
SP - 446
EP - 455
JO - International Journal of Social Psychiatry
JF - International Journal of Social Psychiatry
IS - 5
ER -
