High and long-term users of the mental health services - A case-register study in Italy

Residents of South-Verona who contacted the mental health services in 1983 were traced and followed for a period of 1 year, utilizing a psychiatric case register. Single consulters and long-stay inpatients were excluded from this cohort. A score of service consumption (with subscores for inpatient, day-patient and outpatient care) was calculated for each patient admitted to the study. Seven percent of the patients seeking care in 1 year were high users, having received inpatient as well as day and outpatient care. Using another criterion in classifying the patterns of care, the same sample was divided into long-term and non-long-term users, the former being 9% of the original cohort. The two criteria were then combined to generate four patterns of use of mental health services (high users and long-term users, neither high nor long-term users, high users only, long-term users only). Using log-linear analysis, a strong association was found between the pattern of service use and diagnosis, occupational status and previous psychiatric contacts. No significant higher-order interaction emerged between these three variables and the pattern of service use. © 1986 Springer-Verlag.