Cited by 474Mental Health Treatment and AccessPsychiatric care and mental health servicesPsychology and Mental Health

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Perceived Barriers to Mental Health Service Utilization in the United States, Ontario, and the Netherlands

Sareen, Jitender, Jagdeo, Amit, Cox, Brian J., Clara, Ian, ten Have, Margreet, Belik, Shay-Lee, de Graaf, Ron, Stein, Murray B.·2007·Psychiatric Services

DOI 10.1176/ps.2007.58.3.357

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Abstract

OBJECTIVE: Although rates of mental health service utilization differ dramatically across countries, little information is available about differences in self-reported barriers to mental health service utilization. Perceived barriers were examined in three locations with differing health care systems. METHODS: Data came from three methodologically similar population-based surveys of adults conducted in the 1990s in Ontario, Canada (N=6,261), the United States (N=5,384), and the Netherlands (N=6,031) that assessed DSM-III-R nonpsychotic mental disorders with the Composite International Diagnostic Interview. Respondents who reported a need for professional help were asked to indicate reasons for not seeking care. Multiple logistic regression analyses were used to determine the sociodemographic, mental disorder, and location-specific correlates of each perceived barrier. RESULTS: The pattern of reported barriers to mental health service utilization was similar across locations: attitudinal barriers (thoughts that the problem would get better on its own) were more prevalent than structural barriers (inability to get an appointment). Fear of stigmatization was not commonly endorsed. With adjustment for sociodemographic factors and type of mental disorder, low-income respondents were significantly more likely to report a financial barrier in the United States than in either Ontario or the Netherlands. CONCLUSIONS: Across locations, attitudinal barriers were more likely to be endorsed than structural barriers to service utilization. The most striking reported cross-national difference was structural, with many more U.S. respondents (especially those with low incomes) reporting financial barriers than respondents in either Ontario or the Netherlands.

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Authors: Sareen, J., Jagdeo, A., Cox, B. J., Clara, I., ten Have, M., Belik, S.-L., de Graaf, R., & Stein, M. B.
Affiliations: University of Manitoba (CA)
ORCID: Sareen, Jitender
Cox, Brian J.
Venue: Psychiatric Services
Publisher: American Psychiatric Association Publishing
Published: 2007-03
Volume: 58
Issue: 3
Pages: 357-364
ISSN: 0022-1597 (ISSN-L)
1075-2730
1557-9700
DOI: 10.1176/ps.2007.58.3.357
OpenAlex: W2130770552
Cited by: 470
References: 53
Citations by year: 2026: 13 · 2025: 24 · 2024: 22 · 2023: 41 · 2022: 27 · 2021: 33 · 2020: 31 · 2019: 28 · 2018: 33 · 2017: 28 · 2016: 35 · 2015: 17 · 2014: 30 · 2013: 28 · 2012: 17
FWCI: 19.75
Type: journal article
Language: en
Open access: closed
Locations: Psychiatric Services (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (MH-64122, K24MH064122, R01-MH49098, R01MH049098)
National Institute on Drug Abuse (R01-MH-DA-46376)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords: mental health service utilization, barriers to care, help-seeking, attitudinal barriers, structural barriers, financial barriers, low income, stigma, cross-national comparison, health care system, United States, Ontario, Netherlands
MeSH terms: Adolescent, Adult, Mental Disorders, Cross-Sectional Studies, Demography, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Netherlands, Ontario, Social Perception, Socioeconomic Factors, Stereotyping, United States, Prevalence, Diagnostic and Statistical Manual of Mental Disorders

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Perceived Barriers to Mental Health Service Utilization in the United States, Ontario, and the Netherlands

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