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Cited by 951Mental Health Treatment and AccessPsychology and Mental HealthPsychotherapy Techniques and Applications

Barriers to mental health treatment: results from the National Comorbidity Survey Replication

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Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A. +1 more·2011·Psychological Medicine
DOI 10.1017/s0033291710002291PMC PMC3128692
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Abstract

Background: The aim was to examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the US general population. Method: Respondents in the National Comorbidity Survey Replication with common 12-month DSM-IV mood, anxiety, substance, impulse control and childhood disorders were asked about perceived need for treatment, structural barriers and attitudinal/evaluative barriers to initiation and continuation of treatment. Results: Low perceived need was reported by 44.8% of respondents with a disorder who did not seek treatment. Desire to handle the problem on one's own was the most common reason among respondents with perceived need both for not seeking treatment (72.6%) and for dropping out of treatment (42.2%). Attitudinal/evaluative factors were much more important than structural barriers both to initiating (97.4% v. 22.2%) and to continuing (81.9% v. 31.8%) of treatment. Reasons for not seeking treatment varied with illness severity. Low perceived need was a more common reason for not seeking treatment among individuals with mild (57.0%) than moderate (39.3%) or severe (25.9%) disorders, whereas structural and attitudinal/evaluative barriers were more common among respondents with more severe conditions. Conclusions: Low perceived need and attitudinal/evaluative barriers are the major barriers to treatment seeking and staying in treatment among individuals with common mental disorders. Efforts to increase treatment seeking and reduce treatment drop-out need to take these barriers into consideration as well as to recognize that barriers differ as a function of sociodemographic and clinical characteristics.

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Crossref · 10.1017/s0033291710002291

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  • Many 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 [37]

    The Results (Reasons for not seeking treatment; page unavailable) report structural barriers among respondents with mental disorders who perceived a need for treatment, and the Introduction identifies financial barriers and difficulty obtaining an appointment. The paper does not establish these barriers specifically for face-to-face CBT or for patients with generalized anxiety disorder, nor does it identify lack of trained clinicians or geographical isolation as barriers. (LLM, conf=0.88)

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  • People of color face barriers to care, including limited access to providers, financial and transportation constraints, and stigma.

    “POC face numerous barriers to care, including limited access to providers [37], financial and transportation constraints [38], and stigma [39].”

    From App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (2022) · cites this paper as [38]

    The Methods (page unavailable) identify lack of financial means and transportation as structural barriers to mental health treatment. The Results (page unavailable) find elevated structural barriers among Hispanic respondents compared with non-Hispanic White respondents, but only in mild-to-moderate cases; they do not establish that people of color broadly face both specified barriers. The citation is attached to financial and transportation constraints, not the separate claims about provider access or stigma. (LLM, conf=0.85)

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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 [10]

    The Introduction and Results/Conclusion (page numbers unavailable) identify stigma, structural barriers, and low recognition of treatment need as barriers to seeking mental health care, and recommend public education. They do not establish that these factors explain low endorsement of effective panic disorder treatments specifically; the study addresses treatment seeking across common mental disorders. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Past research has identified significant attitudinal barriers to mental health help-seeking.

    “This emphasis is partly based on the findings of past research that have identified significant attitudinal barriers to mental health help-seeking (8-12).”

    From Attitudes toward mental health help seeking as predictors of future help-seeking behavior and use of mental health treatments (2016) · cites this paper as [9]

  • Stigma, including public stigma and self-stigma, are the main barriers to seeking professional help.

    “Previous results have revealed that stigma, including public stigma and self-stigma, are the main barriers to seeking professional help [39,40,41].”

    From Mental health literacy intervention on help-seeking in athletes: a systematic review (2020) · cites this paper as [40]

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Research works printed but not linked: 2

  1. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV) 1994 American Psychiatric Association Washington, DC Fourth Edition
  2. First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-I/NP) Biometrics Research 2002 New York State Psychiatric Institute New York

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Authors
Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., & Kessler, R. C.
Affiliations
  • Johns Hopkins University (US)
  • New York State Psychiatric Institute (US)
  • Harvard University (US)
  • Emory University (US)
  • National Institute of Mental Health (US)
  • University of California, Los Angeles (US)
  • Columbia University (US)
Corresponding author
Kessler, R. C.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2010-12-07
Volume
41
Issue
8
Pages
1751-1761
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291710002291
PMC
PMC3128692
OpenAlex
W2134566698
Cited by
951
References
47
Citations by year
2026: 46 · 2025: 63 · 2024: 75 · 2023: 71 · 2022: 96 · 2021: 96 · 2020: 104 · 2019: 61 · 2018: 54 · 2017: 95 · 2016: 46 · 2015: 47 · 2014: 43 · 2013: 21 · 2012: 16
FWCI
18.71
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • Substance Abuse and Mental Health Services Administration
  • National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U01-MH-60220, U13MH066849, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (K05DA015799, R01DA016558)
  • Fogarty International Center (R03TW006481)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
barriers to mental health care, treatment seeking, treatment discontinuation, perceived need for treatment, common mental disorders, mood disorders, anxiety disorders, substance use disorders, impulse control disorders, childhood disorders, disease severity, self-management, National Comorbidity Survey Replication
MeSH terms
Adolescent, Adult, Aged, Mental Disorders, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Patient Compliance, Socioeconomic Factors, United States, Health Care Surveys, Young Adult

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