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Barriers to mental health treatment: results from the National Comorbidity Survey Replication

Published online by Cambridge University Press:  07 December 2010

R. Mojtabai ,
M. Olfson ,
N. A. Sampson ,
R. Jin ,
B. Druss ,
P. S. Wang ,
K. B. Wells ,
H. A. Pincus  and
R. C. Kessler
R. Mojtabai
Affiliation:
Department of Mental Health, Bloomberg School of Public Health and Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
M. Olfson
Affiliation:
Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, NY, USA
N. A. Sampson
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
R. Jin
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
B. Druss
Affiliation:
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
P. S. Wang
Affiliation:
Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD, USA
K. B. Wells
Affiliation:
Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
H. A. Pincus
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
R. C. Kessler*
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: Dr R. C. Kessler, Harvard Medical School, Department of Health Care Policy, 180 Longwood Ave., Suite 215, Boston, MA 02115, USA. (Email: [email protected])
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Abstract

Background

The aim was to examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the US general population.

Method

Respondents in the National Comorbidity Survey Replication with common 12-month DSM-IV mood, anxiety, substance, impulse control and childhood disorders were asked about perceived need for treatment, structural barriers and attitudinal/evaluative barriers to initiation and continuation of treatment.

Results

Low perceived need was reported by 44.8% of respondents with a disorder who did not seek treatment. Desire to handle the problem on one's own was the most common reason among respondents with perceived need both for not seeking treatment (72.6%) and for dropping out of treatment (42.2%). Attitudinal/evaluative factors were much more important than structural barriers both to initiating (97.4% v. 22.2%) and to continuing (81.9% v. 31.8%) of treatment. Reasons for not seeking treatment varied with illness severity. Low perceived need was a more common reason for not seeking treatment among individuals with mild (57.0%) than moderate (39.3%) or severe (25.9%) disorders, whereas structural and attitudinal/evaluative barriers were more common among respondents with more severe conditions.

Conclusions

Low perceived need and attitudinal/evaluative barriers are the major barriers to treatment seeking and staying in treatment among individuals with common mental disorders. Efforts to increase treatment seeking and reduce treatment drop-out need to take these barriers into consideration as well as to recognize that barriers differ as a function of sociodemographic and clinical characteristics.

Keywords

Continuity of caremental healthtreatment seeking
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 8 , August 2011 , pp. 1751 - 1761
Copyright
Copyright © Cambridge University Press 2010

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