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Barriers to mental health treatment: results from the National Comorbidity Survey Replication
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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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“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]
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“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]
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“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]
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“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]
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“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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Metadata
- 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.
- 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
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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