Socioeconomic Status and Self-Reported Barriers to Mental Health Service Use
Open accessAbstract
Objective: Socially disadvantaged individuals are at high risk for having their mental health service needs unmet. We explored the relations among education level, income level, and self-reported barriers to mental health service use for individuals with a mental illness, using data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Methods: Our sample group comprised the 8.3% of adult respondents who met the CCHS 1.2 criteria for an anxiety or affective disorder in the past 12 months ( n = 3101). We examined the association between education and income levels and self-reported accessibility, availability, or acceptability barriers to mental health care. Results: Accessibility, availability, and acceptability barriers were reported by 3%, 5%, and 16% of our sample, respectively. Individuals with a high school diploma were less likely than individuals without a high school diploma to report acceptability barriers to care (odds ratio 0.65; 95% confidence interval, 0.45 to 0.93). Higher-income individuals were less likely than lower-income individuals to report acceptability barriers to care (odds ratio 0.69; 95% confidence interval, 0.50 to 0.96). Employment, distress level, age, and family structure were also associated with acceptability barriers. Conclusion: Issues related to acceptability explain most of the unmet need for mental health services. Program planners should consider the development of targeted approaches to service delivery and outreach for low-income, working individuals who have not completed high school.
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The treatment gap is larger for people with low SES and for those in low-income countries, even after adjustment for disorder severity.
“This gap is even greater for people with low socio-economic status (SES) and those living in low-income countries (Steele et al. 2007; Ormel et al. 2008) even adjusting for disorder severity (Mojtabai, 2010; Andrade et al. 2014).”
From Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: Results from the WHO World Mental Health (WMH) surveys (2018) · cites this paper as Steele et al. 2007
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- Authors
- Steele, L., Dewa, C., & Lee, K.
- Affiliations
- St. Michael's Hospital (CA)
- Centre for Addiction and Mental Health (CA)
- ORCID
- Dewa, Carolyn
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2007-03
- Volume
- 52
- Issue
- 3
- Pages
- 201-206
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W71472000
- Cited by
- 152
- References
- 13
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 10 · 2023: 4 · 2022: 13 · 2021: 7 · 2020: 10 · 2019: 6 · 2018: 10 · 2017: 11 · 2016: 7 · 2015: 7 · 2014: 7 · 2013: 8 · 2012: 6
- FWCI
- 9.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Canadian Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centre for Addiction and Mental Health
- Ontario Ministry of Health and Long-Term Care
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Keywords
- socioeconomic status, mental health service utilization, barriers to care, access barriers, educational attainment, income level, anxiety disorders, mood disorders, unmet mental health needs, low-income adults, employment, family structure
- MeSH terms
- Adult, Anxiety Disorders, Mental Disorders, Canada, Cross-Sectional Studies, Depressive Disorder, Employment, Family, Female, Health Services Accessibility, Humans, Male, Mental Health Services, Surveys and Questionnaires, Socioeconomic Factors
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