Help-Seeking Behavior and Treatment Barriers in Anxiety Disorders: Results from a Representative German Community Survey
Open accessAbstract
Although effective therapies exist, treatment rates of anxiety disorders (AD) are low, raising the question why affected individuals do not receive treatment. We provide data from the nationally representative German Health Interview and Examination Survey-2011 (DEGS1) on the help-seeking behavior and perceived treatment barriers of 650 subjects with Diagnostic and Statistical Manual of Mental Disorders’ (DSM-IV AD). Only 26% of all cases with AD in the community reported having had contact with mental health services because of their anxiety problems in their lifetime. 16% were currently receiving professional help, most frequently by psychotherapists (8%), psychiatrists (5%) and general practitioners (5%). 40% of all cases never even considered seeking help and 31% reported barriers to treatment, such as self-reliance (18%) or beliefs that treatments were ineffective (9%), unavailable (8%) or too stigmatizing (7%). Measures to increase treatment rates should thus target individual as well as public attitudes and health literacy to increase awareness of and access to evidence-based interventions.
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Individuals with GAD report a higher number of barriers to treatment compared to individuals with other anxiety disorders.
“individuals with GAD report a higher number of barriers to treatment compared to individuals with other anxiety disorders”
From Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder (2024) · cites this paper as Heinig et al., 2021
The Results (Treatment Barriers; page unavailable) say that treatment barriers were reported most frequently among people with GAD (46.6%). That compares the proportion of people reporting barriers, not the number of barriers each individual reported; the latter comparison is not established in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredOnly two studies have examined the treatment barriers of individuals with GAD.
“only two studies have examined the treatment barriers of individuals with GAD”
From Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder (2024) · cites this paper as Heinig et al., 2021
The Introduction (page unavailable) says disorder-specific treatment-barrier profiles have rarely been reported, and the Results > Treatment Barriers section reports findings for GAD. Neither passage establishes that exactly two studies have examined treatment barriers in people with GAD. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIndividuals with GAD were more likely to perceive barriers to treatment than individuals with other anxiety disorders.
“individuals with GAD were more likely to perceive barriers to treatment than individuals with other anxiety disorders”
From Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder (2024) · cites this paper as Heinig et al., 2021
In a GAD sample, wanting to solve one's own mental health problem was the most cited barrier, with unavailability of treatment and perceived ineffectiveness of treatment as the second and third most cited barriers.
“wanting to solve one's own mental health problem the most cited barrier, it identified unavailability of treatment and perceived ineffectiveness of treatment as the second and third most cited barriers among a GAD sample”
From Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder (2024) · cites this paper as Heinig et al., 2021
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Cited by
Sorted by citations
Niermann, H. C. M., Voss, C., Pieper, L., Venz, J., Ollmann, T. M., & Beesdo-Baum, K. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102453 · Cited by 39 · see citing works
Basile, V. T., Newton‐John, T., & Wootton, B. M. (2024) · Journal of Clinical Psychology · doi:10.1002/jclp.23665 · Cited by 15 · see citing works
- Authors
- Heinig, I., Wittchen, H.-U., & Knappe, S.
- Affiliations
- Technische Universität Dresden (DE)
- Corresponding author
- Heinig, Ingmar
- Venue
- Community Mental Health Journal
- Published
- 2021-01-20
- Volume
- 57
- Issue
- 8
- Pages
- 1505-1517
- ISSN
- 0010-3853 (ISSN-L)
- 1573-2789
- PMC
- PMC8531057
- OpenAlex
- W3123513771
- Cited by
- 54
- References
- 31
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 12 · 2023: 8 · 2022: 7 · 2021: 3
- FWCI
- 7.35
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Community Mental Health Journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- Funders
- Projekt DEAL
- 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 › Psychological Treatments and Disorders
- Keywords
- help-seeking, anxiety disorders, barriers to treatment, mental health service utilization, treatment beliefs, mental health stigma, health literacy, community mental health
- MeSH terms
- Help-Seeking Behavior, Anxiety Disorders, Germany, Humans, Mental Health Services, Patient Acceptance of Health Care, Surveys and Questionnaires
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