The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.
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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“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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Screening for serious mental illness in the general population
Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S.-L. T., Manderscheid, R. W., Walters, E. E., et al. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.2.184 · Cited by 5,692
Perceived Need and Help-Seeking in Adults With Mood, Anxiety, or Substance Use Disorders
Mojtabai, R., Olfson, M., & Mechanic, D. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.1.77 · Cited by 710 · cited 1×
“In countries where mental health services are primarily offered in the private sector, the concept of social disadvantage as it relates to service use is often tightly yoked to income levels or insurance coverage.(16) Under universal health care coverage, other elements of social disadvantage emerge as major predictor…”
BackgroundWang, P. S., Berglund, P., & Kessler, R. C. (2000) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2000.9908044.x · Cited by 686 · cited 1×
“Anxiety and affective disorders are more common in lower-education and lower-income groups.(3,4) However, Canadian data show higher rates of specialty mental health service use in individuals with high education levels—and smaller or no differences in service use rates by income level.”
BackgroundSocioeconomic position and major mental disorders
Muntaner, C. (2004) · Epidemiologic Reviews · doi:10.1093/epirev/mxh001 · Cited by 631
The Canadian Community Health Survey: Mental Health and Well-Being
Gravel, R. G., & Béland, Y. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001002 · Cited by 306
Income Differences in Persons Seeking Outpatient Treatment for Mental Disorders
Alegria, M. M., Bijl, R. V., Lin, E. H. B., Walters, E. E., & Kessler, R. C. (2000) · Archives of General Psychiatry · doi:10.1001/archpsyc.57.4.383 · Cited by 210
Vasiliadis, H., LESAGE, A. D., Adair, C. E., & Boyer, R. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001007 · Cited by 139
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Unmet Need for the Treatment of Depression in Atlantic Canada
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Inequity in Mental Health Care Under Canadian Universal Health Coverage
Steele, L. S., Glazier, R. H., & Lin, E. H. B. (2006) · Psychiatric Services · doi:10.1176/appi.ps.57.3.317 · Cited by 82
Self-citation
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Sorted by citations
Evans-Lacko, S., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Benjet, C., Bruffaerts, R., Chiu, W. T., Florescu, S., de Girolamo, G., Gureje, O., et al. (2018) · Psychological Medicine · doi:10.1017/s0033291717003336 · Cited by 781
“Why did we find weaker and less consistent associations of income and education with treatment than previous studies (Rossi et al. 2005; Tello et al. 2005; Steele et al. 2007)?”
BackgroundResultInfluentialWomen’s Attitudes, Preferences, and Perceived Barriers to Treatment for Perinatal Depression
Goodman, J. H. (2009) · Birth · doi:10.1111/j.1523-536x.2008.00296.x · Cited by 526
Efficacy of peer support interventions for depression: a meta-analysis
Pfeiffer, P. N., Heisler, M., Piette, J. D., Rogers, M. A. M., & Valenstein, M. (2011) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.10.002 · Cited by 484
Probst, C., Roerecke, M., Behrendt, S., & Rehm, J. T. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyu043 · Cited by 271
Poverty and Mental Health: How Do Low‐Income Adults and Children Fare in Psychotherapy?
Santiago, C. D., Kaltman, S. I., & Miranda, J. M. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21951 · Cited by 269
Metadata
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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