Bibliographic record
Abstract
Introduction: Chronic pain is an important global health issue, and mental health conditions frequently co-occur together. Additionally, a significant proportion of people living with chronic pain (PLWCP) may develop opioid use problems from prescribed opioid medications. Psychological interventions can have a positive effect on pain, co-occurring mental health conditions, as well as on reducing opioid medication doses. Still, access to such services is generally considered to be problematic due to barriers such as costs, stigma, and service availability. PLWCP may encounter additional access barriers due to population-specific characteristics such as pain-related distress and disability, trauma, unemployment, and more. This thesis aims to evaluate the accessibility of mental health services for PLWCP. Methods: Two studies were conducted in the context of this thesis. In the first study, a narrative review of the literature on the utilization of mental health services by PLWCP was completed. This review was based on 9 articles reporting the proportion of PLWCP that had used any type of mental health services (i.e. mental health services or consultations with mental health professionals). In the second study, an online survey to evaluate the perceived needs for mental health care (MHC) of a sample of PLWCP in Quebec was completed. The survey was distributed to members of the Quebec Chronic Pain Association, and on social media. Results: In the first study, the narrative review helped identify 9 articles, where 15 reports of mental health service utilization by PLWCP were identified. Nine of these reports pertained to the utilization of mental health services for pain-related reasons, whereas the remaining 6 reports concerned service mental health service utilization for mental health-related reasons. On average, only a quarter of study samples had used mental health services for any of the two reasons (M = 24%; 95% CI [13%-35%]). The utilization of mental health services for mental health-related reasons represented a higher proportion of participants (M = 35.6%; 95% CI [11%-60%]), than their utilization for pain-related reasons (M = 16.1%; 95% CI [9%-23%]). In the second study, a total of 140 participants were recruited. Of these, 82 participants reported a need for MHC to manage mental health problems in terms of information, medication, and counselling or psychotherapy. Results showed that only 16% of this sample indicated that all of their perceived MHC needs were met, and 40% indicated that none of their perceived MHC needs were met. Conclusions: The two studies carried out in the context of this thesis indicate that the accessibility of MHC for the chronic pain population seems to be sub-optimal. Overall, findings from this thesis suggest that the chronic pain population is not currently using mental health services to the degree to which they could benefit from them and that they may have unmet perceived needs for MHC. It is important to address these gaps to improve the treatment of chronic pain and co-occurring mental health problems, as well as to contribute to reducing the reliance on opioid medications and their negative consequences
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".