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Shortfall in mental health service utilisation
Open accessAbstract
Background: Treatment coverage for mental disorders is poor in most developed countries. Aims: To explore some reasons for the poor treatment coverage for mental disorders in developed countries. Method: Data were taken from Australian national surveys and from the World Health Report. Results: Only one-third of people with a mental disorder consulted. Probability of consulting varied by diagnosis: 90% for schizophrenia, which is accounted for by external factors; 60% for depression; and 15% for substance use and personality disorders. The probability of consulting varied by gender, age, marital status and disability, from 73% among women aged 25–54 years, disabled and once married to 9% among males without these risk factors. Those who did not consult but were disabled or comorbid said that they “preferred to manage themselves”. Data from five countries showed no evidence that overall health expenditure, out-of-pocket cost or responsiveness of the health system affected the overall consulting rates. Conclusions: Societal, attitudinal and diagnostic variables account for the variation. Funding does not. Public education about the recognition and treatment of mental disorders and the provision of effective treatment by providers might remedy the shortfall.
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“However, only 16.7% of people who suffer from anxiety disorders seek help from a mental health professional, and of these individuals, only 21.3% receive CBT, which is arguably the most effective treatment [8].”
From Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial. (2014) · cites this paper as [8]
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“Despite the severity of these consequences, it is estimated that up to one-half of those with depression [16-18] and only one third to one-half of those affected by anxiety disorders [8,16] seek professional help.”
From A systematic review of help-seeking interventions for depression, anxiety and general psychological distress (2012) · cites this paper as [8]
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“However, only 16.7% of people who suffer from anxiety disorders seek help from a mental health professional, and of these individuals, only 21.3% receive CBT, which is arguably the most effective treatment [8].”
From Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial. (2014) · cites this paper as [8]
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“Only 35% of young people experiencing mental health problems seek professional face-to-face help [91,92].”
From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [92]
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Incongruence and attitudes toward career counseling
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“Research also shows that most people with mental health disorders, regardless of their sexual identity, do not seek out mental health services more broadly and even fewer seek psychotherapy/counseling more specifically (Andrews et al., 2001; Medley et al., 2016; Wang et al., 2005).”
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“One explanation for this may be that men tend to seek help only after experiencing a sharp deterioration in their mental or physical condition [3,12,92] and then require several types of interventions (medication, counselling, etc.”
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“); (3) Repeated studies from multiple databases; (4) Studies for which the full text is not available.”
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“Similarly, an estimated two-third of Australian adults who meet the criteria for a mental disorder do not consult a mental health professional [41].”
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“In particular, seeking help for mental health problems is significantly less common in men than women (Andrews et al., 2001; McManus et al., 2016; Yousaf et al., 2015).”
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“The first of them is related to the general reluctance of people to receive professional psychological help (Andrews, Issakidis, & Carter, 2001).”
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“Australian National Probability Sample Surveys [1] found that only 37% of people with current mental disorders had sought help through consultation.”
Background
Metadata
- Authors
- Andrews, G., Issakidis, C., & Carter, G.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Andrews, Gavin
- ORCID
- Andrews, Gavin
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2001-11
- Volume
- 179
- Issue
- 5
- Pages
- 417-425
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2082102545
- Cited by
- 420
- References
- 27
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 17 · 2021: 20 · 2020: 16 · 2019: 15 · 2018: 20 · 2017: 18 · 2016: 19 · 2015: 23 · 2014: 33 · 2013: 25 · 2012: 24
- FWCI
- 13.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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, treatment coverage, help-seeking, mental illness, schizophrenia, depression, substance use disorders, personality disorders, gender differences, disability, comorbidities, self-management, health care costs, out-of-pocket costs, health system responsiveness, mental health funding, public education
- MeSH terms
- Adolescent, Adult, Aged, Attitude to Health, Australia, Mental Disorders, Female, Humans, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Perception, Regression Analysis, Sex Factors, Socioeconomic Factors, Odds Ratio
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