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Subsidized Psychological Treatment for Nine Traumatic and Adverse Events
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Abstract:
Background: The Danish Health Care System (DHCS) provides financial subsidies for psychological treatment after nine types of traumatic and adverse events (e.g., accidents, sexual abuse, serious illness). Objectives: To investigate 1) What are the characteristics of the people using the public subsidy for psychological treatment compared with the general population? 2) Which social, somatic, and psychiatric differences exist between the patients from each of the nine referral categories compared with the general population? Methods: This study combines nationwide individual-level data from the DHCS with other administrative data and includes everyone who lived in Denmark and received subsidized treatment during 2014-2023. These individuals are compared with the general population living in Denmark. Results: In the ten-year period, 361,152 individuals used the DHCS for psychological treatment, 76% being women. Unexpectedly, a considerable decrease in the use of public subsidies was found among all trauma types. The categories with the most help-seeking individuals were bereavement, disabling disease, and having relatives with disabling diseases, constituting two-thirds of all contacts. In all categories, women used the subsidy more frequently than men. The number of treatment sessions received by the users was quite stable across referral categories. Although many predictors were statistically significant, they did not explain much of the variation, except for treatment seekers who had attempted suicide or experienced childhood sexual abuse. Anxiety and mood disorders were the most consistent predictors for seeking treatment across the 9 categories. Conclusions: Despite its universal coverage, the DHCS only subsidized psychologist treatment for a small and decreasing share of the population. Most users of the health scheme have experienced loss and disabling illnesses. Demographic factors and preceding diseases were significant and common but weak predictors for all the referral categories.
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