Barriers to mental health service use among distressed family caregivers of lung cancer patients
Open accessAbstract
Although family caregivers of patients with lung and other cancers show high rates of psychological distress, they underuse mental health services. This qualitative study aimed to identify barriers to mental health service use among 21 distressed family caregivers of lung cancer patients. Caregivers had not received mental health services during the patient's initial months of care at a comprehensive cancer centre in New York City. Thematic analysis of interview data was framed by Andersen's model of health service use and Corrigan's stigma theory. Results of our analysis expand Andersen's model by providing a description of need variables (e.g. psychiatric symptoms), enabling factors (e.g. finances), and psychosocial factors associated with caregivers' non-use of mental health services. Regarding psychosocial factors, caregivers expressed negative perceptions of mental health professionals and a desire for independent management of emotional concerns. Additionally, caregivers perceived a conflict between mental health service use and the caregiving role (e.g. prioritising the patient's needs). Although caregivers denied stigma associated with service use, their anticipated negative self-perceptions if they were to use services suggest that stigma may have influenced their decision to not seek services. Findings suggest that interventions to improve caregivers' uptake of mental health services should address perceived barriers.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Caregivers often cannot access services due to constraints such as time, finances, travel, patient-focused view, lack of resources, negative perceptions of mental health professionals and services, and stigma avoidance.
“caregivers often cannot access services due to a variety of constraints (e.g., time, finances, travel, patient-focused view, lack of resources, negative perceptions of mental health professionals and services, stigma avoidance) [23–25].”
From It is time to address fear of cancer recurrence in family caregivers: protocol for the feasibility and acceptability of a randomized pilot study of the online version of the Family Caregiver–Fear Of Recurrence Therapy (FC-FORT) (2024) · cites this paper as [25]
The Results (Qualitative Findings; page unavailable) identify expense, limited financial resources, prioritizing the patient, negative views of mental health professionals, and stigma avoidance as reasons caregivers did not seek services. Caregivers also described not wanting to take time away from family. The paper does not identify travel as a barrier, and it frames these findings largely as decisions not to seek care rather than an inability to access it. (LLM, conf=0.87)
Experimental — accuracy not yet measuredEmbarrassment and service utilization have been connected in a sample of caregivers of medically vulnerable adults.
“Embarrassment and service utilization have been connected in a sample of caregivers of medically vulnerable adults [35].”
From Dimensions of caregiver strain may partially mediate the relationship between youth symptomology and counseling utilization among Latinxs (2024) · cites this paper as [35]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?
Andersen, R. M. (1995) · Journal of Health and Social Behavior · doi:10.2307/2137284 · Cited by 9,831 · see citing works
The validity of the Hospital Anxiety and Depression Scale
Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00296-3 · Cited by 9,779 · cited 5× · see citing works
“Eighty percent of caregivers agreed to be screened for psychological distress using the HADS to determine their eligibility status, 18% declined to participate, and 2% were unable to be reached via phone.”
BackgroundInfluentialHow stigma interferes with mental health care.
Corrigan, P. (2004) · American Psychologist · doi:10.1037/0003-066x.59.7.614 · Cited by 3,648 · see citing works
Livingston, J. D., & Boyd, J. E. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.09.030 · Cited by 1,677 · see citing works
The self–stigma of mental illness: implications for self–esteem and self–efficacy
Corrigan, P. W., Watson, A. C., & Barr, L. (2006) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2006.25.8.875 · Cited by 1,406 · see citing works
Stigma and Help Seeking for Mental Health Among College Students
Eisenberg, D., Downs, M. F., Golberstein, E., & Zivin, K. (2009) · Medical Care Research and Review · doi:10.1177/1077558709335173 · Cited by 1,193 · see citing works
Measuring the self-stigma associated with seeking psychological help
Vogel, D. L., Wade, N. G., & Haake, S. (2006) · Journal of Counseling Psychology · doi:10.1037/0022-0167.53.3.325 · Cited by 1,190 · cited 3× · see citing works
“One psychosocial factor linked to nonuse of mental health services is internalized stigma (Livingston & Boyd, 2010; Vogel et al., 2006).”
BackgroundBarriers to mental health treatment: results from the National Comorbidity Survey Replication
Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., & Kessler, R. C. (2011) · Psychological Medicine · doi:10.1017/s0033291710002291 · Cited by 951 · see citing works
The stigma of mental illness: Explanatory models and methods for change
Corrigan, P. W., Kerr, A. N., & Knudsen, L. (2005) · Applied and Preventive Psychology · doi:10.1016/j.appsy.2005.07.001 · Cited by 550 · see citing works
Psychosocial Care for Family Caregivers of Patients With Cancer
Northouse, L., Williams, A.-L., Given, B., & McCorkle, R. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.39.5798 · Cited by 527 · see citing works
Self-citationHidden morbidity in cancer: spouse caregivers
Braun, M., Mikulincer, M., Rydall, A., Walsh, A., & Rodin, G. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2006.10.0909 · Cited by 526 · see citing works
Sareen, J., Jagdeo, A., Cox, B. J., Clara, I., ten Have, M., Belik, S.-L., de Graaf, R., & Stein, M. B. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.3.357 · Cited by 470 · see citing works
Quality of life of family caregivers of cancer survivors: Across the trajectory of the illness
Kim, Y., & Given, B. A. (2008) · Cancer · doi:10.1002/cncr.23449 · Cited by 463 · see citing works
Self-citationThomas, C., Morris, S., & Harman, J. (2002) · Social Science & Medicine · doi:10.1016/s0277-9536(01)00048-x · Cited by 301 · see citing works
Psychiatric Disorders and Mental Health Service Use Among Caregivers of Advanced Cancer Patients
Vanderwerker, L. C., Laff, R. E., Kadan-Lottick, N. S., McColl, S., & Prigerson, H. G. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.01.370 · Cited by 270 · cited 6× · see citing works
“Discussion Family caregivers of cancer patients show high rates of psychological distress (M. Braun et al., 2007; Fridriksdóttir et al., 2011), but typically underuse mental health services (Mosher et al., 2013a; Vanderwerker et al., 2005).”
BackgroundInfluentialMENTAL ILLNESS STIGMA AND CARE SEEKING
Cooper, A., Corrigan, P. W., & Watson, A. C. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000066157.47101.22 · Cited by 258 · see citing works
Eakin, E., & Strycker, L. A. (2001) · Psycho-Oncology · doi:10.1002/pon.500 · Cited by 223 · see citing works
Family members of cancer patients: Needs, quality of life and symptoms of anxiety and depression
Friðriksdóttir, N., Sævarsdóttir, Þ., Halfdánardóttir, S. Í., Jónsdóttir, A., Magnúsdóttir, H., Ólafsdóttir, K. L., Guðmundsdóttir, G., & Gunnarsdóttir, S. (2011) · Acta Oncologica · doi:10.3109/0284186x.2010.529821 · Cited by 196 · see citing works
Understanding the Experience of Caregivers: A Focus on Transitions
Blum, K., & Sherman, D. W. (2010) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2010.08.005 · Cited by 194 · see citing works
Rüsch, N., Corrigan, P. W., Wassel, A., Michaels, P., Larson, J. E., Olschewski, M., Wilkniss, S., & Batia, K. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.067157 · Cited by 188 · see citing works
Wolff, J. L. (2007) · Archives of Internal Medicine · doi:10.1001/archinte.167.1.40 · Cited by 156 · see citing works
Dhingra, S. S., Zack, M., Strine, T., Pearson, W. S., & Balluz, L. (2010) · Psychiatric Services · doi:10.1176/ps.2010.61.5.524 · Cited by 144 · see citing works
Lambert, S. D., Girgis, A., Lecathelinais, C., & Stacey, F. (2013) · Supportive Care in Cancer · doi:10.1007/s00520-012-1495-7 · Cited by 135 · see citing works
Sleep-Wake Disturbances in Patients with Advanced Cancer and Their Family Carers
Gibbins, J. L., McCoubrie, R., Kendrick, A. H., Senior-Smith, G., Davies, A. N., & Hanks, G. W. (2009) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2009.04.025 · Cited by 104 · see citing works
Perceived Stigma and Help-Seeking Behavior: Longitudinal Evidence From the Healthy Minds Study
Golberstein, E., Eisenberg, D., & Gollust, S. E. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.9.1254 · Cited by 95 · see citing works
Elhai, J. D., & Ford, J. D. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.8.1108 · Cited by 89 · see citing works
Lambert, S. D., Jones, B. L., Girgis, A., & Lecathelinais, C. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-012-9385-2 · Cited by 87 · see citing works
Group-Based Trajectory Modeling of Caregiver Psychological Distress Over Time
Choi, C.-W. J., Stone, R. A., Kim, K. H., Ren, D., Schulz, R., Given, C. W., Given, B. A., & Sherwood, P. R. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-012-9371-8 · Cited by 84 · see citing works
Self-citationMosher, C. E., Jaynes, H., Hanna, N., & Ostroff, J. (2012) · Supportive Care in Cancer · doi:10.1007/s00520-012-1532-6 · Cited by 72 · see citing works
Self-citationMosher, C. E., Champion, V. L., Hanna, N., Jalal, S. I., Fakiris, A. J., Birdas, T. J., Okereke, I. C., Kesler, K. A., Einhorn, L. H., Given, B. A., et al. (2013) · Psycho-Oncology · doi:10.1002/pon.3168 · Cited by 65 · cited 10× · see citing works
“Discussion Family caregivers of cancer patients show high rates of psychological distress (M. Braun et al., 2007; Fridriksdóttir et al., 2011), but typically underuse mental health services (Mosher et al., 2013a; Vanderwerker et al., 2005).”
BackgroundInfluentialSelf-citationThe Role of Blame in the Psychosocial Adjustment of Couples Coping with Lung Cancer
Milbury, K., Badr, H., & Carmack, C. L. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-012-9402-5 · Cited by 42 · see citing works
Smoking Concordance in Lung and Colorectal Cancer Patient-Caregiver Dyads and Quality of Life
Weaver, K. E., Rowland, J. H., Augustson, E. M., & Atienza, A. A. (2011) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-10-0666 · Cited by 42 · see citing works
Complications of Lung Cancer Treatment
Spiro, S. G., Douse, J., Read, C., & Janes, S. M. (2008) · Seminars in Respiratory and Critical Care Medicine · doi:10.1055/s-2008-1076750 · Cited by 27 · see citing works
Lobchuk, M., Murdoch, T., McClement, S., & McPherson, C. J. (2008) · Cancer Nursing · doi:10.1097/01.ncc.0000339253.68324.19 · Cited by 23 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Li, Y., Li, J., Zhang, Y., Ding, Y., & Hu, X. (2022) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2022.104179 · Cited by 130 · see citing works
Köhle, N., Drossaert, C. H. C., Van Uden-Kraan, C. F., Schreurs, K. M. G., Hagedoorn, M., Verdonck-de Leeuw, I. M., & Bohlmeijer, E. T. (2018) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2017.1397831 · Cited by 16 · see citing works
Lamarche, J., Nissim, R., Avery, J., Wong, J., Maheu, C., Lambert, S. D., Laizner, A. M., Jones, J., Esplen, M. J., & Lebel, S. (2024) · Pilot and Feasibility Studies · doi:10.1186/s40814-024-01567-4 · Cited by 4 · see citing works
Vázquez, A. L., Culianos, D., Gudiño, O. G., Navarro Flores, C. M., Barrett, T. S., & Domenech Rodríguez, M. M. (2024) · PLoS ONE · doi:10.1371/journal.pone.0302575 · Cited by 3 · see citing works
“Embarrassment and service utilization have been connected in a sample of caregivers of medically vulnerable adults [35].”
Background
- Authors
- Mosher, C. E., Given, B. A., & Ostroff, J. S.
- Affiliations
- Indiana University – Purdue University Indianapolis (US)
- Michigan State University (US)
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Mosher, C.E.
- Venue
- European Journal of Cancer Care
- Publisher
- Wiley
- Published
- 2014-04-25
- Volume
- 24
- Issue
- 1
- Pages
- 50-59
- ISSN
- 0961-5423 (ISSN-L)
- PMC
- PMC4209195
- OpenAlex
- W1592421094
- Cited by
- 77
- References
- 36
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 14 · 2023: 14 · 2022: 8 · 2021: 7 · 2020: 6 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 4
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Cancer Care (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Cancer Institute (R03CA139862, F32CA130600, P30CA008748)
- National Center for Research Resources (KL2 RR025760)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- family caregivers, lung cancer, mental health service utilization, barriers to care, psychological distress, caregiver burden, stigma, psychosocial factors, financial barriers, comprehensive cancer center
- MeSH terms
- Adult, Aged, Emotions, Family, Female, Humans, Lung Neoplasms, Male, Mental Health Services, Middle Aged, Surveys and Questionnaires, Self Concept, Stress, Psychological, Caregivers, Qualitative Research, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
