Cited by 878Mental Health Treatment and AccessGender Roles and Identity StudiesPsychology and Mental Health

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Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes

Mackenzie, C. S., Gekoski, W. L., Knox, V. J.·2006·Aging & Mental Health

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Abstract

The objectives of this study were to explore age and gender differences in attitudes toward seeking professional psychological help, and to examine whether attitudes negatively influence intentions to seek help among older adults and men, whose mental health needs are underserved. To achieve these objectives 206 community-dwelling adults completed questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-seeking, and intentions to seek help. Older age and female gender were associated with more positive help-seeking attitudes in this sample, although age and gender interacted with marital status and education, and had varying influences on different attitude components. Age and gender also influenced intentions to seek professional psychological help. Women exhibited more favourable intentions to seek help from mental health professionals than men, likely due to their positive attitudes concerning psychological openness. Older adults exhibited more favourable intentions to seek help from primary care physicians than younger adults, a finding that was not explained by age differences in attitudes. Results from this study suggest that negative attitudes related to psychological openness might contribute to men's underutilization of mental health services. Help-seeking attitudes do not appear to be a barrier to seeking professional help among older adults, although their intentions to visit primary care physicians might be. These findings suggest the need for education to improve men's help-seeking attitudes and to enhance older adults' willingness to seek specialty mental health services.

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Age Group Differences Among Veterans Enrolled in a Clinical Service for Behavioral Health Issues in Primary Care
Mavandadi, S., Klaus, J. R., & Oslin, D. W. (2010) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181ec828a · Cited by 6
Measuring and predicting mental health literacy for depression
Swannell, E. J., & McDermott, M. R. (2015) · International Journal of Mental Health Promotion · doi:10.1080/14623730.2015.1089010 · Cited by 6
Una propuesta para abordar la doble ceguera: la Terapia Familiar Crítica sensible al Género.
Macías-Esparza, L. K., & Ortíz, E. L. (2017) · Revista de Psicoterapia · doi:10.33898/rdp.v28i106.143 · Cited by 6
Health Literacy in Context—Settings, Media, and Populations
Nutbeam, D., Levin‐Zamir, D., & Rowlands, G. (2019) · MDPI eBooks · doi:10.3390/books978-3-03897-472-7 · Cited by 6
Qué significa la recuperación para las personas usuarias de servicios de salud mental en Cataluña
Sampietro, H. M., Carmona, V. R., Sicilia, L., Castet, C. G., Rojo, E., & Gómez‐Benito, J. (2022) · Quaderns de Psicologia · doi:10.5565/rev/qpsicologia.1880 · Cited by 7
“…aspectos que afectan a la salud mental y la recuperación, por ejemplo: el autoestigma y la disposición a buscar ayuda (Eisenberg et al., 2009; Mackenzie et al., 2006); la vinculación a los servicios de salud mental (Temkin-Greenyr y Clark, 1988); las actitudes hacia el tratamiento (González…”
Background
Acceptability and feasibility of using avatar‐based virtual world software as an adjunct to clinical interventions, training, and reflective practice in a medium secure setting: A qualitative interview study
Mason, K., Bicknell, S., Kreutzer, E., Wood, A., & Hurlow, J. M. (2022) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.2264 · Cited by 7
Age Group Differences in Mental Health Care Preferences and Barriers among Latinos
Dupree, L. W., Herrera, J. R., Tyson, D. M., Jang, Y., & King‐Kallimanis, B. L. (2010) · Best practices in mental health · doi:10.70256/098402asnkrw · Cited by 6
Psychometric Properties of the Inventory of Attitudes Toward Seeking Mental Health Services (Chinese Version)
Tieu, Y., Konnert, C. A., & Quigley, L. (2018) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980818000041 · Cited by 10
“We assessed intentions to seek mental health services using a procedure adapted from prior research (Mackenzie et al., 2006).”
BackgroundMethodResultInfluential
Self-Reported Likelihood of Seeking Social Worker Help Among Older Men in Israel
Kagan, M., Itzick, M., Even‐Zohar, A., & Zychlinski, E. (2018) · American Journal of Men s Health · doi:10.1177/1557988318801655 · Cited by 6
Integrated decision-making model for community-based rehabilitation service utilisation among persons with severe mental illness in China: protocol for a cross-sectional, mixed-methods study
Wang, R., Tang, S., SHAW, I. F., Feng, Z., Chen, Z., Luo, Y., Song, H., Wu, T., Fu, Q., Fu, H., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-021528 · Cited by 6
Is exposure to family member incarceration during childhood linked to diabetes in adulthood? Findings from a representative community sample
White, B. A., West, K. J., & Fuller‐Thomson, E. (2020) · SAGE Open Medicine · doi:10.1177/2050312120905165 · Cited by 6
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Gahm, G. A., Reger, G. M., Ingram, M. V., Reger, M. A., & Rizzo, A. (2012) · doi:10.21236/ada579116 · Cited by 6
Young onset dementia : characteristics and impact
van Vliet, D. (2012) · doi:10.26481/dis.20120920dv · Cited by 6
Impact of Telephone-Based Problem-Solving Treatment on the Use of Medical and Psychological Services in the Military
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“(H7) Personal values will be assessed with the Portrait Values Questionnaire 21 (PVQ21, ESS21) 66 , adapted in a gender-neutral form.”
BackgroundMethod
Barriers and Facilitators of Psychological Help-Seeking of People With Depression, Anxiety, and Stress Symptoms Among ASEAN Countries: A Systematic Review
Syafitri, D. U., Mawaddah, S., Lau, J. Y. F., & Brown, J. S. L. (2025) · International Journal of Social Psychiatry · doi:10.1177/00207640251367289 · Cited by 9
“Various studies have documented that being female increases the likelihood of seeking help in different countries (S. B. Kim & Lee, 2022) because females generally have higher psychological openness (Mackenzie et al., 2006).”
The impact of self-stigma on college students' attitudes toward professional psychological help-seeking: serial-mediated effects of discrimination perceptions and core self-evaluations
Chen, D., Wu, Y., Qian, L., & Zhou, Y. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1630323 · Cited by 5
An explorative study of factors associated with treatment in specialized mental health care centers among GP patients in Norway
Tveit, O. G., Ruud, T., Hanssen‐Bauer, K., Haavet, O. R., & Hussain, A. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06982-4 · Cited by 6
“This is consistent with the reduced help-seeking behavior seen among men [9, 10].”
BackgroundResult
Pilot outcomes of a filmmaking intervention designed to enhance treatment entry and social reintegration of veterans.
Drebing, C. E., Mamon, D., Calixte, R. M., Tuval‐Mashiach, R., Patton, B., Scoglio, A. A. J., Girouard, C. M., Fukuda, S., Gao, W., & Penk, W. E. (2022) · Psychological Services · doi:10.1037/ser0000618 · Cited by 7
Predictive modeling of initiation and delayed mental health contact for depression
Panaite, V., Finch, D. K., Pfeiffer, P., Cohen, N., Alman, A. C., Haun, J. N., Schultz, S. K., Miles, S. R., Belanger, H. G., Kozel, F. A., et al. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-10870-y · Cited by 5
“These beliefs taken to extreme can promote emotional avoidance and may inadvertently delay treatment seeking [16, 17].”
Background
Sex and gender reporting in RCTs of internet and mobile-based interventions for depression and anxiety in chronic conditions: A secondary analysis of a systematic review
Corrick, S., Johnson, E., Isley, S., Vandermeer, B., Dolgoy, N. D., Bates, J., Godfrey, E., Soltys, C., Muir, C., Tegg, N. L., et al. (2024) · PLOS mental health. · doi:10.1371/journal.pmen.0000048 · Cited by 6
Utilization and engagement with an employer-provided digital mental health platform: An international perspective
Maistrello, G., Phillips, W., Lee, D., & Romanelli, R. J. (2024) · Digital Health · doi:10.1177/20552076241277180 · Cited by 5
“Previous studies suggest that older adults, especially men, are less willing to seek specialty mental health services, 80 and are also less likely to seek talking therapies compared to younger population, 81 which partially supports our ﬁ ndings.”
Background
Is the effect of ill health on school achievement among Swedish adolescents gendered?
Bortes, C., Strandh, M., & Nilsson, K. (2019) · SSM - Population Health · doi:10.1016/j.ssmph.2019.100408 · Cited by 5
Gender differences in the interaction effect of community resources and attitudes toward seeking professional help on posttraumatic stress, depression, and posttraumatic growth
Shigemoto, Y., Banks, A., & Boxley, B. (2019) · Journal of Community Psychology · doi:10.1002/jcop.22287 · Cited by 6
Associations of time perspectives and attitudes towards seeking professional psychological help
Kiss, D., Szél, Z., Gyarmathy, A., & Rácz, J. (2020) · Polish Psychological Bulletin · doi:10.24425/ppb.2020.132652 · Cited by 5
“female gender trough openness (Mackenzie et al., 2006) male gender trough rigid masculinity (Gonzalez et al.”
Background
Intersectionality, Gender, and the Self-Stigma of Mental Illness
Dubke, R. E., & Corrigan, P. W. (2021) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2021.40.2.145 · Cited by 5
Unique cessation tools in the box: Quitline utilization and effectiveness trends among a large sample of tobacco users reporting mental health disorders
Hart, J. T., Boeckman, L. M., & Beebe, L. A. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.869802 · Cited by 5
“The link between increased willingness to engage in helpseeking and being female, as well as, links between willingness to acknowledge MHDs for females and younger people has been established in previous research (32, 33).”
Result
Help-seeking following a flooding event: a cross-sectional analysis of adults affected by flooding in England in winter 2013/14
Findlater, L., Robin, C., Hopgood, K., Waite, T., National Study of Flooding and Health Study Group, Waite, T., Beck, C., Oliver, I., Amlôt, R., Bone, A., et al. (2023) · European Journal of Public Health · doi:10.1093/eurpub/ckad082 · Cited by 5
Rates and correlates of study enrolment and use of a chatbot aimed to promote mental health services use for eating disorders following online screening
D’Adamo, L., Grammer, A. C., Rackoff, G. N., Shah, J., Firebaugh, M., Taylor, C. B., Wilfley, D. E., & Fitzsimmons‐Craft, E. E. (2024) · European Eating Disorders Review · doi:10.1002/erv.3082 · Cited by 5
Effect of marital status on duration of treatment for mental illness
Wu, Z., Schimmele, C. M., Penning, M. J., Zheng, C., & Noh, S. (2012) · Canadian Studies in Population · doi:10.25336/p6690z · Cited by 5
“That said, previous studies demonstrate that there is a non-significant difference between the married and the never-married in the utilization of mental health services (e.g., Kimerling et al. 1999; MacKenzie, Gekoski, and Knox 2006; Mojtabai and Olfson 2006).”
Exploring Indices of Disordered Eating Literacy in Male and Female Athletes: Knowledge Gaps and Lay Beliefs as Predictors of Attitudes Toward Help-Seeking
McArdle, S., & Moore, P. (2013) · Journal of Clinical Sport Psychology · doi:10.1123/jcsp.7.4.275 · Cited by 5
Do as I Say, Not as I Do? An Examination of the Relationship Between Partner Behaviors and Help Seeking for Alcohol Related Issues
Fleming, C. E. (2016) · Substance Use & Misuse · doi:10.3109/10826084.2016.1160933 · Cited by 5
Multi-Morbid Health Profiles and Specialty Healthcare Service Use: A Moderating Role of Poverty
Kwon, I., Shin, O., Park, S., & Kwon, G. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16111956 · Cited by 6
“When older individuals have mental health or substance abuse problems, they are more likely to visit primary care physicians than to seek professional healthcare services [21,22].”
Background
Çocuk ve ergen psikiyatrisi polikliniğine başvuran hastaların başvuru biçimi, şikayet, tanı ve eştanı dağılımları
Alan, B. E. (2019) · Turkish Journal of Clinics and Laboratory · doi:10.18663/tjcl.511659 · Cited by 5

Authors: Mackenzie, C. S., Gekoski, W. L., & Knox, V. J.
Affiliations: Queen's University (CA)
Corresponding author: Mackenzie, C. S.
ORCID: Mackenzie, C. S.
Venue: Aging & Mental Health
Publisher: Informa UK Limited
Published: 2006-11
Volume: 10
Issue: 6
Pages: 574-582
ISSN: 1360-7863 (ISSN-L)
1364-6915
DOI: 10.1080/13607860600641200
OpenAlex: W2014172961
Semantic Scholar: d232506e2297dea5f6d1729b555e7bd93577103f
Cited by: 878
References: 42
Citations by year: 2026: 48 · 2025: 51 · 2024: 75 · 2023: 79 · 2022: 71 · 2021: 63 · 2020: 60 · 2019: 69 · 2018: 51 · 2017: 48 · 2016: 40 · 2015: 48 · 2014: 40 · 2013: 36 · 2012: 29
FWCI: 13.83
Type: journal article
Language: en
Open access: closed
Locations: Aging & Mental Health (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Gender Studies › Gender Roles and Identity Studies
Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords: help-seeking attitudes, mental health service utilization, underutilization of mental health services, age differences, gender differences, older adults, men, help-seeking intentions, open-mindedness, primary care mental health, psychiatric symptoms, help-seeking barriers
MeSH terms: Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Mental Disorders, Demography, Educational Status, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Mental Health Services, Middle Aged, Ontario, Patient Acceptance of Health Care, Personality Inventory, Surveys and Questionnaires, Regression Analysis, Sex Factors, Marital Status

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Age, gender, and the underutilization of mental health services: The influence of help-seeking attitudes

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