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The prevalence and service utilisation associated with mental and substance use disorders in Lao People’s Democratic Republic: findings from a cross-sectional survey

Published online by Cambridge University Press:  24 July 2017

F. Charlson ,
S. Diminic ,
C. Choulamany ,
D. Santomauro ,
S. Raja  and
H. Whiteford
F. Charlson*
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
S. Diminic
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia
C. Choulamany
Affiliation:
BasicNeeds, 158A Parade, Leamington Spa, Warwickshire CV32 4AE, UK
D. Santomauro
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
S. Raja
Affiliation:
BasicNeeds, 158A Parade, Leamington Spa, Warwickshire CV32 4AE, UK
H. Whiteford
Affiliation:
Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia School of Public Health, University of Queensland, Brisbane, Australia Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
*
*Address for correspondence: F. Charlson, Policy and Epidemiology Group, Queensland Centre for Mental Health Research, The Park - Centre for Mental Health, Locked Bag 500, Archerfield QLD 4108 Australia. (Email: fiona_charlson@qcmhr.uq.edu.au)
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Abstract

Aims.

An epidemiological survey was conducted to determine the prevalence of the mental and substance use disorders and ascertain patterns of mental health services utilisation in Lao People's Democratic Republic (Lao PDR) with the aim of evaluating existing gaps and opportunities in the provision of mental health services.

Methods.

This study was a cross-sectional, household survey of adults living within Vientiane Capital province, Lao PDR. We collected data on participant demographics, mental and physical health status, family history of mental illness and exposure to potential risk factors. It also collected data on mental health service utilisation patterns, types of health professionals and treatment being accessed, barriers to treatment and perceived need for care. The MINI International Neuropsychiatric Interview (MINI v.6.0) was also administered to assess mental disorder prevalence.

Results.

Age- and sex-standardised current prevalence of any disorder was estimated at 15.2% (95% CI 11.0–20.7). Alcohol dependence (5.5% (95% CI 3.2–9.6)), was the most prevalent followed by anxiety disorders (5.2% (95% CI 3.2–8.3)) and mood disorders (2.5% (95% CI 1.5–4.4)). 11.0% (95% CI 5.8–20.1) of participants with a mental and/or substance use disorder suffered from other comorbid disorders. A number of variables demonstrated significant effects in final logistic regression models, including family history, education and employment for mental disorders; and gender, numbers of hours worked per week and number of dependants for substance use disorders. Having a mental or substance use disorder was associated with an OR of 11.6 of suicidality over participants without a mental or substance use disorder (95% CI 2.8–58.5). Of the 101 participants who met criteria for a current mental or substance use disorder, only two (2.1% (95% CI 0.5–8.0)) had accessed services for their mental health in the past 12 months. No participants who had seen a health professional in the past 12 months reported getting as much help as they needed. The vast majority (89.2% (95% CI 76.5–95.4)) of participants meeting criteria for a current mental or substance use disorder reported that they had not experienced mental health problems in the past 12 months.

Conclusions.

This study presents the first epidemiological estimates for a range of mental and substance use disorders in the general population of the most populous province in Lao PDR. A large treatment gap exists for mental and substance use disorders in Lao PDR. This research adds value for health care and has been an important precursor to developing informed and targeted mental health policy, services and health system reform in Lao PDR.

Keywords

Lao PDRsubstance useepidemiologymental healthpopulation survey
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 28 , Issue 1 , February 2019 , pp. 54 - 65
Copyright
Copyright © Cambridge University Press 2017 

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