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Health Service Utilization for Mental, Behavioural and Emotional Problems among Conflict-Affected Population in Georgia: A Cross-Sectional Study

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  • Ivdity Chikovani
  • Nino Makhashvili
  • George Gotsadze
  • Vikram Patel
  • Martin McKee
  • Maia Uchaneishvili
  • Natia Rukhadze
  • Bayard Roberts

Abstract

Background: There is large gap in mental illness treatment globally and potentially especially so in war-affected populations. The study aim was to examine health care utilization patterns for mental, behavioural and emotional problems among the war-affected adult population in the Republic of Georgia. Methods: A cross-sectional household survey was conducted among 3600 adults affected by 1990s and 2008 armed conflicts in Georgia. Service use was measured for the last 12 months for any mental, emotional or behavioural problems. TSQ, PHQ-9 and GAD-7 were used to measure current symptoms of PTSD, depression and anxiety. Descriptive and regression analyses were used. Results: Respondents were predominantly female (65.0%), 35.8% were unemployed, and 56.0% covered by the government insurance scheme. From the total sample, 30.5% had symptoms of at least one current mental disorder. Among them, 39.0% sought care for mental problems, while 33.1% expressed facing barriers to accessing care and so did not seek care. General practitioners (29%) and neurologists (26%) were consulted by the majority of those with a current mental disorder who accessed services, while use of psychiatric services was far more limited. Pharmacotherapy was the predominant type of care (90%). Female gender (OR 1.50, 95% CI: 1.25, 1.80), middle-age (OR 1.83, 95% CI: 1.48, 2.26) and older-age (OR 1.62, 95% CI: 1.19, 2.21), possession of the state insurance coverage (OR 1.55, 95% CI: 1.30, 1.86), current PTSD symptoms (OR 1.56, 95% CI: 1.29, 1.90) and depression (OR 2.12, 95% CI: 1.70, 2.65) were associated with higher rates of health service utilization, while employed were less likely to use services (OR 0.71, 95% CI: 0.55, 0.89). Conclusions: Reducing financial access barriers and increasing awareness and access to local care required to help reduce the burden of mental disorders among conflict-affected persons in Georgia.

Suggested Citation

  • Ivdity Chikovani & Nino Makhashvili & George Gotsadze & Vikram Patel & Martin McKee & Maia Uchaneishvili & Natia Rukhadze & Bayard Roberts, 2015. "Health Service Utilization for Mental, Behavioural and Emotional Problems among Conflict-Affected Population in Georgia: A Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-17, April.
    • Handle: RePEc:plo:pone00:0122673
    DOI: 10.1371/journal.pone.0122673
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    References listed on IDEAS

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    1. Nino Makhashvili & Robert van Voren, 2013. "Balancing Community and Hospital Care: A Case Study of Reforming Mental Health Services in Georgia," PLOS Medicine, Public Library of Science, vol. 10(1), pages 1-5, January.
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    Cited by:

    1. McDaid, David & Park, A-La, 2023. "Making an economic argument for investment in global mental health: the case of conflict-affected refugees and displaced people," LSE Research Online Documents on Economics 118149, London School of Economics and Political Science, LSE Library.
    2. Tess Bright & Sarah Wallace & Hannah Kuper, 2018. "A Systematic Review of Access to Rehabilitation for People with Disabilities in Low- and Middle-Income Countries," IJERPH, MDPI, vol. 15(10), pages 1-34, October.
    3. Singh, Namrita S. & Bass, Judith & Sumbadze, Nana & Rebok, George & Perrin, Paul & Paichadze, Nino & Robinson, W. Courtland, 2018. "Identifying mental health problems and Idioms of distress among older adult internally displaced persons in Georgia," Social Science & Medicine, Elsevier, vol. 211(C), pages 39-47.
    4. Seguin, Maureen & Lewis, Ruth & Razmadze, Mariam & Amirejibi, Tinatin & Roberts, Bayard, 2017. "Coping strategies of internally displaced women in Georgia: A qualitative study," Social Science & Medicine, Elsevier, vol. 194(C), pages 34-41.
    5. Gregorius Abanit Asa & Nelsensius Klau Fauk & Lillian Mwanri & Paul Russell Ward, 2021. "Understanding Barriers to the Access to Healthcare and Rehabilitation Services: A Qualitative Study with Mothers or Female Caregivers of Children with a Disability in Indonesia," IJERPH, MDPI, vol. 18(21), pages 1-14, November.

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