Barriers to treatment seeking for anxiety disorders: initial data on the role of mental health literacy
Open accessAbstract
BACKGROUND: Anxiety disorders represent the single largest mental health problem in the United States [Greenberg et al., 1999. J Clin Psychiatry 60:427-435; Rice and Miller, 1998. Br J Psychiatry 173:4-9]. However most individuals with anxiety disorders never seek treatment [Henderson et al., 2002. Can J Psychiatry 47:819-824; Mojtabai et al., 2002. Arch Gen Psychiatry 59:77-84; Roness et al., 2005. Acta Psychiatr Scand 111:51-58]. Deficits in the ability to recognize anxiety disorders and beliefs about them, (i.e., "mental health literacy") may contribute to low levels of help seeking. METHODS: Survey data assessing mental health literacy for multiple anxiety disorders and for depression were collected from 284 undergraduate students enrolled in psychology courses at a public university in the United States. Specifically, respondents were presented with vignettes portraying individuals experiencing various forms of mental illness and were asked to label the disorder, its cause and whether or not they would recommend treatment. RESULTS: Findings showed that social phobia and obsessive compulsive disorder (OCD) were associated with recognition rates that were generally high and similar to depression (approximately 80%). In contrast, less than half of the respondents labeled panic disorder or generalized anxiety disorder (GAD) correctly. Symptoms of OCD were attributed to mental illness by approximately 50% of respondents, but such attributions were rare for the other anxiety disorders studied (<12%). Finally, data on help-seeking recommendations suggested that such recommendations are far from universal and varied between different anxiety disorders and according to perceptions of the causes of symptoms. CONCLUSIONS: Given that the current sample was well-educated young adults, mental health literacy of the general public may be even lower.
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Low endorsement of effective panic disorder treatments is attributable to barriers including a lack of psychoeducation, fear of stigmatization, and structural barriers such as lack of access to adequate treatments.
“The reasons for this low endorsement of effective PD treatments include a lack of psychoeducation, a fear of stigmatization, and structural barriers such as a lack of access to adequate treatments [9, 10].”
From Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial. (2014) · cites this paper as [9]
The introduction and Problem Recognition section link limited mental-health literacy to treatment seeking and report that fewer than half of respondents correctly identified panic disorder. This partly supports an education-related explanation, but the paper does not establish fear of stigmatization or lack of access as reasons for low endorsement of effective panic-disorder treatments. Its Recommendations to Seek Professional Help section instead reports that four in five respondents recommended professional help for the panic-disorder vignette. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMany patients with generalized anxiety disorder experience logistical barriers when accessing face-to-face cognitive behavioral therapy, including cost, difficulty accessing a trained clinician, and geographical isolation.
“many patients experience logistical barriers when accessing face-to-face CBT”
From Internet videoconferencing delivered cognitive behavior therapy for generalized anxiety disorder: protocol for a randomized controlled trial (2022) · cites this paper as [10]
The introductory section reports that many people with anxiety disorders do not seek treatment, while the study focuses on mental health literacy as a possible barrier. Searches for face-to-face CBT, treatment cost, clinician access, and geographical isolation found no passage addressing those logistical barriers; the reported societal cost of anxiety disorders is not a patient access cost. No page numbers were available in our copy. (LLM, conf=0.76)
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Self-citation
- Authors
- Coles, M. E., & Coleman, S. L.
- Affiliations
- Binghamton University (US)
- Corresponding author
- Coles, Meredith E.
- ORCID
- Coles, Meredith E.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2010-01
- Volume
- 27
- Issue
- 1
- Pages
- 63-71
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W1963832195
- Cited by
- 204
- References
- 49
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 11 · 2023: 9 · 2022: 11 · 2021: 30 · 2020: 27 · 2019: 13 · 2018: 9 · 2017: 15 · 2016: 11 · 2015: 10 · 2014: 12 · 2013: 12 · 2012: 9
- FWCI
- 6.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- mental health literacy, treatment seeking, anxiety disorders, help-seeking barriers, social anxiety disorder, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, depression, symptom recognition, beliefs about mental illness, undergraduate students
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Attitude to Health, Awareness, Diagnosis, Differential, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Obsessive-Compulsive Disorder, Patient Acceptance of Health Care, Phobic Disorders, Students, United States, Panic Disorder, Young Adult, Health Literacy
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