Perceived barriers to care in St. Louis (USA) and Christchurch (NZ): Reasons for not seeking professional help for psychological distress

ArticleinSocial Psychiatry and Psychiatric Epidemiology 29(4):155-64 · August 1994with28 Reads
Impact Factor: 2.54 · DOI: 10.1007/BF00802012 · Source: PubMed

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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    • "It is well known that individuals with chronic pain make more contact points with the health care system [13, 14] . In contrast, literature suggests that persons with psychosocial conditions , such as partnership problems and social stress are less likely to visit the primary health care system for those psychosocial reasons, but more for physical complaints151617. Primary health care is recognized as a focal point for customized and effective management of psychosocial conditions, especially those in combination with chronic pain181920212223. "
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    Full-text · Article · Jul 2015 · PLoS ONE
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    • "Barriers to seeking professional help were measured using the Barriers to Care Checklist (BTCC)333435. The checklist begins with the question 'Have you received professional help for mental health problems in the last 12 months?' "
    [Show abstract] [Hide abstract] ABSTRACT: This study investigated the relationship between acculturation and psychological problems in Turkish and Moroccan young adults living in the Netherlands. A sample of 131 healthy young adults aged between 18 and 24 years old, with a Turkish or Moroccan background was recruited using snowball sampling. Data on acculturation, internalizing and externalizing problems, beliefs about psychological problems, attributions of psychological problems and barriers to care were collected and analyzed using Latent Class Analysis and multinomial logistic regression. Three acculturation classes were identified in moderately to highly educated, healthy Turkish or Moroccan young adults: integration, separation and diffusion. None of the participants in the sample were marginalized or assimilated. Young adults reporting diffuse acculturation reported more internalizing and externalizing problems than those who were integrated or separated. Separated young adults reported experiencing more practical barriers to care than integrated young adults. Further research with a larger sample, including young adult migrants using mental health services, is required to improve our understanding of acculturation, psychological problems and barriers to care in this population. Including experiences of discrimination in the model might improve our understanding of the relationship between different forms of acculturation and psychological problems.
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