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Brief Reports   |    
Physicians’ Influence on Primary Care Patients’ Reluctance to Use Mental Health Treatment
Tzipi Hornik-Lurie, M.A.; Yaacov Lerner, M.D.; Nelly Zilber, D.ès Sc.; Marjorie C. Feinson, Ph.D.; Julie G. Cwikel, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300064
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Ms. Hornik-Lurie and Dr. Cwikel are with the Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel (e-mail: tzipi58@zahav.net.il). Ms. Hornik-Lurie is also with the Falk Institute for Mental Health Studies, Kfar-Shaul Hospital, Jerusalem, where Dr. Lerner, Dr. Zilber, and Dr. Feinson are affiliated. Dr. Cwikel is also with the Center for Women’s Health and Promotion at the Ben-Gurion University of the Negev.

Copyright © 2014 by the American Psychiatric Association


Objectives  The study examined attitudes of primary care patients toward mental health treatment and whether ambivalent or negative attitudes change after patients receive recommendations from their primary care physicians to seek treatment from a mental health professional.

Methods  Data were collected in face-to-face interviews with 902 Jewish patients aged 25–75 in eight primary care clinics in Israel. Measures included validated mental health instruments and a vignette eliciting patients’ readiness to consider treatment and potential influence of a physician’s recommendation.

Results  Initially, almost half of patients were reluctant to consider specialized mental health treatment. The probability of having a more positive attitude after the physician’s recommendation was significantly higher among patients with more severe clinical diagnoses.

Conclusions  A major finding was the positive impact of primary care physicians’ recommendations on reluctant patients. Encouraging physicians to discuss mental health issues would likely promote more positive attitudes and increase patients’ willingness to access treatment.

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Table 1Attitudes toward seeking treatment from a mental health professional, by patient characteristicsa
Table Footer Note

a Proportions were compared by using chi square tests. Missing cases were as follows: place of birth, N=15; age, N=12; education, N=6; marital status, N=1; religious observance, N=2; sufficiency of family income, N=15; subjective psychological distress, N=2.

Table Footer Note

b Western countries were defined as Europe (except the former Soviet Union), North America, and South Africa.

Table Footer Note

c A t score of 63 or higher in the overall 18-item Brief Symptom Inventory score (Global Severity Index) indicates psychological distress.

Table Footer Note

d Anxiety included general anxiety, panic attacks, and obsessive-compulsive disorder.



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