Perceived barriers to care in St. Louis (USA) and Christchurch (NZ): reasons for not seeking professional help for psychological distress.
ABSTRACT This paper examines perceived barriers to mental health care reported in two very similar community surveys in two cities that are not only on opposite sides of the world but that differ substantially in their health care systems, their size, and their mix of ethnic groups, namely, St. Louis in the United States and Christchurch in New Zealand. Respondents were asked about mental health care ever received, any failure to seek care when required, and symptoms of 14 psychiatric disorders according to DSM-III. The frequency with which respondents reported not seeking care and the popularity of specific reasons for not seeking care were almost identical in the two sites. A common reason offered for not seeking care was doubt about the need for professional help; this appeared to be particularly common for people with alcohol disorder. Respondents who said that they had failed to seek care when needed gave reasons that were mainly attitudinal, such as believing they should be strong enough to cope without professional help. Structural characteristics of services such as cost, times open, and travel distance were given less often. Sociodemographic factors had small or negligible effect on care seeking.
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ABSTRACT: Although rates of treatment seeking for mental health problems are increasing, this increase is driven primarily by antidepressant medication use, and a majority of individuals with mental health problems remain untreated. Helpseeking attitudes are thought to be a key barrier to mental health service use, although little is known about whether such attitudes have changed over time. Research on this topic is mixed with respect to whether helpseeking attitudes have become more or less positive. The aim of the current study was to help clarify this issue using a cross-temporal meta-analysis of scores on Fischer and Turner's (1970) helpseeking attitude measure among university students (N=6796) from 1968 to 2008. Results indicated that attitudes have become increasingly negative over time, r(44)=-0.53, p<0.01, with even stronger negative results when the data are weighted (w) for sample size and study variance, r(44)=-0.63, p<.001. This disconcerting finding may reflect the greater emphasis of Fischer and Turner's scale toward helpseeking for psychotherapy. Such attitudes may be increasingly negative as a result of the unintended negative effects of efforts in recent decades to reduce stigma and market biological therapies by medicalizing mental health problems.Clinical psychology review 12/2013; 34(2):99-106. DOI:10.1016/j.cpr.2013.12.001 · 7.18 Impact Factor
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ABSTRACT: This study has a dual purpose: 1) identify determinants of healthcare service utilization for mental health reasons (MHR) in a Canadian (Montreal) catchment area; 2) determine the patterns of recourse to healthcare professionals in terms of frequency of visits and type of professionals consulted, and as it relates to the most prevalent mental disorders (MD) and psychological distress. Data was collected from a random sample of 1,823 individuals interviewed after a two-year follow-up period. A regression analysis was performed to identify variables associated with service utilization and complementary analyses were carried out to better understand participants' patterns of healthcare service utilization in relation to the most prevalent MD. Among 243 individuals diagnosed with a MD in the 12 months preceding an interview, 113 (46.5%) reported having used healthcare services for MHR. Determinants of service utilization were emotional and legal problems, number of MD, higher personal income, lower quality of life, inability of individuals to influence events occurring in their neighborhood, female gender and, marginally, lack of alcohol dependence in the past 12 months. Emotional problems were the most significant determinant of healthcare service utilization. Frequent visits with healthcare professionals were more likely associated with major depression and number of MD with or without dependence to alcohol or drugs. People suffering from major depression, psychological distress and social phobia were more likely to consult different professionals, while individuals with panic disorders relied on their family physician only. Concerning social phobia, panic disorders and psychological distress, more frequent visits with professionals did not translate into involvement of a higher number of professionals or vice-versa. This study demonstrates the impact of emotional problems, neighborhood characteristics and legal problems in healthcare service utilization for MHR. Interventions based on inter-professional collaboration could be prioritized to increase the ability of healthcare services to take care especially of individuals suffering from social phobia, panic disorders and psychological distress. Others actions that could be prioritized are training of family physicians in the treatment of MD, use of psychiatric consultants, internet outreach, and reimbursement of psychological consultations for individuals with low income.BMC Health Services Research 04/2014; 14(1):161. DOI:10.1186/1472-6963-14-161 · 1.66 Impact FactorThis article is viewable in ResearchGate's enriched formatRG Format enables you to read in context with side-by-side figures, citations, and feedback from experts in your field.
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ABSTRACT: Introduction. The paper reports on an exploratory study of the usefulness of Twitter for unobtrusive assessment of stigmatizing attitudes in the community. Materials and Methods. Tweets with the hashtags #depression or #schizophrenia posted on Twitter during a 7-day period were collected. Tweets were categorised based on their content and user information and also on the extent to which they indicated a stigmatising attitude towards depression or schizophrenia (stigmatising, personal experience of stigma, supportive, neutral, or anti-stigma). Tweets that indicated stigmatising attitudes or personal experiences of stigma were further grouped into the following subthemes: social distance, dangerousness, snap out of it, personal weakness, inaccurate beliefs, mocking or trivializing, and self-stigma. Results and Discussion. Tweets on depression mostly related to resources for consumers (34%), or advertised services or products for individuals with depression (20%). The majority of schizophrenia tweets aimed to increase awareness of schizophrenia (29%) or reported on research findings (22%). Tweets on depression were largely supportive (65%) or neutral (27%). A number of tweets were specifically anti-stigma (7%). Less than 1% of tweets reflected stigmatising attitudes (0.7%) or personal experience of stigma (0.1%). More than one third of the tweets which reflected stigmatising attitudes were mocking or trivialising towards individuals with depression (37%). The attitude that individuals with depression should "snap out of it" was evident in 30% of the stigmatising tweets. The majority of tweets relating to schizophrenia were categorised as supportive (42%) or neutral (43%). Almost 10% of tweets were explicitly anti-stigma. The percentage of tweets showing stigmatising attitudes was 5%, while less than 1% of tweets described personal experiences of stigmatising attitudes towards individuals with schizophrenia. Of the tweets that indicated stigmatising attitudes, most reflected inaccurate beliefs about schizophrenia being multiple personality disorder (52%) or mocked or trivialised individuals with schizophrenia (33%). Conclusions. The study supports the use of analysis of Twitter content to unobtrusively measure attitudes towards mental illness, both supportive and stigmatising. The results of the study may be useful in assisting mental health promotion and advocacy organisations to provide information about resources and support, raise awareness and counter common stigmatising attitudes.10/2014; In press. DOI:10.7717/peerj.647