Self‐reported use of mental health services versus administrative records: care to recall?
Open accessAbstract
Estimates of the level of unmet need for mental health treatment often rely on self‐reported use of mental health services. However, depressed persons may over‐report their use in relation to administrative records if they are highly distressed. This study seeks to replicate and explicate the finding that persons at a high level of distress report more mental health service use than recorded in their healthcare records. The study sample, N=36,892, 12 years and older, was drawn from the 1996/97 Ontario portion of the Canadian National Population Health Survey. Respondents were individually linked to their administrative mental healthcare records 12 months backward in time. Of these, 96.5% agreed to the link and 23,063 (62.5%) were linked. Almost two‐thirds of those who were depressed in the past year were currently at a high level of distress. Differential reporting of use for highly distressed persons in excess of 100% remained in the use of different types of physician providers after adjustments for other potential determinants of use. Telescoping was also not an explanation. The patterns of differential reporting between groups expected to diverge and converge in their recall ability were consistent with a recall bias. As this study was not able to rule out a recall bias, it further accentuates concerns about the impact of bias in the measurement of mental health‐service use and inferences made concerning the determinants of use. Copyright © 2004 Whurr Publishers Ltd.
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Treatment measures were limited to self-reports, which have been found to over-estimate treatment compared to administrative records.
“Third, the treatment measures were limited to self-reports, which have been found to over-estimate treatment compared to administrative records (Rhodes & Fung, 2004).”
From Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: Results from the WHO World Mental Health (WMH) surveys (2018) · cites this paper as Rhodes & Fung, 2004
The Abstract reports that highly distressed people reported more mental-health service use than appeared in their administrative records. But the claim presents overestimation as a general property of self-reported treatment measures; the paper limits the finding to particular groups and notes in the Introduction that people may also under-report use. The paper does not establish that the citing study’s own treatment measures were overestimates. (LLM, conf=0.88)
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References 38 · Cited by 120
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- Authors
- Rhodes, A. E., & Fung, K.
- Affiliations
- St. Michael's Hospital (CA)
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Rhodes, Anne E.
- Venue
- International Journal of Methods in Psychiatric Research
- Publisher
- Wiley
- Published
- 2004-08
- Volume
- 13
- Issue
- 3
- Pages
- 165-175
- ISSN
- 1049-8931 (ISSN-L)
- 1557-0657
- PMC
- PMC6878470
- OpenAlex
- W2059921773
- Cited by
- 120
- References
- 38
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 9 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 4 · 2014: 6 · 2013: 5 · 2012: 6
- FWCI
- 7.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Methods in Psychiatric Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institute for Clinical Evaluative Sciences
- Ontario Ministry of Health and Long-Term Care
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- mental health service utilization, administrative records, recall bias, measurement bias, depression, distress, unmet mental health needs, data linkage, physician care
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Depressive Disorder, Major, Major Depressive Disorder, Female, Health Surveys, Humans, Insurance Claim Review, Male, Medical Record Linkage, Medical Records, Mental Health Services, Middle Aged, National Health Programs, Ontario, Patient Care Team, Mental Recall, Self Disclosure, Utilization Review, Bias, Episode of Care
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