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Journal ArticleDOI

Perceived barriers to mental health service use among individuals with mental disorders in the Canadian general population.

01 Feb 2006-Medical Care (Med Care)-Vol. 44, Iss: 2, pp 192-195
TL;DR: Clinical characteristics play an important role in perceiving barriers to mental health care and future efforts should pay particular attention to the needs of those with chronic and severe mental health problems and focus on improving the effectiveness of mental health services.
Abstract: Background:Eliminating barriers to care is important for improving health service use. However, the barriers to mental health care have not been well investigated.Objectives:This study was designed to provide information about the barriers to mental health service use and to identify clinical factor
Citations
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Journal ArticleDOI
TL;DR: Findings demonstrated relatively low treatment utilization rates among the sample, with many participants receiving treatments other than the gold‐standard medication and psychotherapy treatments (i.e. SSRIs and cognitive behavioral therapy, respectively).
Abstract: Background: Despite the increasing dissemination of treatment for Obsessive–Compulsive Disorder (OCD) in the past decade, the majority of individuals with OCD are not receiving appropriate treatment. This study examined rates of treatment utilization and barriers to treatment in an internet sample of individuals with self-reported OCD. Methods: One hundred and seventy-five participants completed an online survey examining OCD symptoms, psychosocial measures, barriers to treatment, and treatment utilization. Results: Sixty percent of the sample reported receiving treatment for their OCD symptoms. The majority of participants who sought pharmacotherapy received SSRIs, whereas the majority who sought psychotherapeutic treatment received “talk therapy.” The cost of treatment, lack of insurance coverage, shame, and doubt that treatment would be effective were the most commonly endorsed barriers to treatment among the sample. Conclusions: Findings demonstrated relatively low treatment utilization rates among the sample, with many participants receiving treatments other than the gold-standard medication and psychotherapy treatments (i.e. SSRIs and cognitive behavioral therapy, respectively). Furthermore, a large portion of the sample endorsed many barriers to treatment seeking, such as logistic and financial barriers; stigma, shame, and discrimination barriers; and treatment perception and satisfaction barriers. This study highlights the need for more effective treatment dissemination in OCD. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.

225 citations


Cites result from "Perceived barriers to mental health..."

  • ...These findings corroborate earlier research that has demonstrated that shame and concerns about the acceptability of treatment are significant impediments to treatment-seeking for individuals with OCD and other mental illnesses.([15,41,42]) Further research is needed to determine whether the experience of shame and discrimination is different for individuals with OCD compared to individuals with other psychological disorders....

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Journal ArticleDOI
TL;DR: Concerns about stigma and barriers to care tended to be more prominent among personnel who met criteria for a mental health problem, and the pattern of reported stigma and barrier to care was similar across the Armed Forces of all five nations.
Abstract: SummaryObjectivesMilitary organizations are keen to address barriers to mental health care yet stigma and barriers to care remain little understood, especially potential cultural differences betwee...

165 citations

Journal Article
TL;DR: People with elevated levels of distress are significantly more likely to have unmet and partially met MHC needs than to have fully met M HC needs, regardless of the presence of mental or substance disorders.
Abstract: Background Past research and national survey data on Canadians' perceived need for mental health care (MHC) have focused on unmet needs overall, and have not considered specific types of MHC needs or the extent to which needs are met. Data and methods Using data from the 2012 Canadian Community Health Survey-Mental Health, this article describes the prevalence of perceived MHC needs for information, medication, counselling and other services. The degree to which each type of need was met is explored. Associations between risk factors for having MHC needs and the extent to which needs were met are investigated. Results In 2012, an estimated 17% of the population aged 15 or older reported having had an MHC need in the past 12 months. Two-thirds (67%) reported that their need was met; for another 21%, the need was partially met; and for 12%, the need was unmet. The most commonly reported need was for counselling, which was also the least likely to be met. Distress was identified as a predictor of perceived MHC need status. Interpretation Many Canadians are estimated to have MHC needs, particularly for counselling. People with elevated levels of distress are significantly more likely to have unmet and partially met MHC needs than to have fully met MHC needs, regardless of the presence of mental or substance disorders.

140 citations

Journal ArticleDOI
TL;DR: In Canada, a large percentage of individuals who use mental health services prematurely terminate their treatment, and patients with substance dependence and those with mood disorders have a high risk of treatment dropout.
Abstract: Background:Dropping out of mental health treatment prematurely may affect treatment outcome. However, we have limited knowledge about the epidemiology of mental health treatment dropout. The objectives of this analysis were to estimate the rates of dropout in individuals who had received mental heal

134 citations


Cites background from "Perceived barriers to mental health..."

  • ...It is possible that “other reasons” may be related to the accessibility and availability of mental health services, which have been found to be significant barriers to accessing mental health services.(28) This analysis found that clinical characteristics were important factors for mental health treatment dropout....

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Journal ArticleDOI
TL;DR: A systematic review of the literature found 5 distinct SARs used in research to investigate the potential for this technology to address mental health and psychological well-being outcomes and synthesizes and describes the nascent empirical literature of SARs in mental health research.
Abstract: Background: Technology-assisted clinical interventions are increasingly common in the health care field, often with the proposed aim to improve access to and cost-effectiveness of care. Current technology platforms delivering interventions are largely mobile apps and online websites, although efforts have been made to create more personalized and embodied technology experiences. To extend and improve on these platforms, the field of robotics has been increasingly included in conversations of how to deliver technology-assisted, interactive, and responsive mental health and psychological well-being interventions. Socially assistive robots (SARs) are robotic technology platforms with audio, visual, and movement capabilities that are being developed to interact with individuals socially while also assisting them with management of their physical and psychological well-being. However, little is known about the empirical evidence or utility of using SARs in mental health interventions. Objective: The review synthesizes and describes the nascent empirical literature of SARs in mental health research and identifies strengths, weaknesses, and opportunities for improvement in future research and practice. Methods: Searches in Medline, PsycINFO, PsycARTICLES, PubMed, and IEEE Xplore yielded 12 studies included in the final review after applying inclusion and exclusion criteria. Abstract and full-text reviews were conducted by two authors independently. Results: This systematic review of the literature found 5 distinct SARs used in research to investigate the potential for this technology to address mental health and psychological well-being outcomes. Research on mental health applications of SARs focuses largely on elderly dementia patients and relies on usability pilot data with methodological limitations. Conclusions: The current SARs research in mental health use is limited in generalizability, scope, and measurement of psychological outcomes. Opportunities for expansion of research in this area include diversifying populations studied, SARs used, clinical applications, measures used, and settings for those applications.

124 citations

References
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Journal ArticleDOI
TL;DR: An overview of the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview (CIDI) is presented and a discussion of the methodological research on which the development of the instrument was based is discussed.
Abstract: This paper presents an overview of the World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) and a discussion of the methodological research on which the development of the instrument was based. The WMH-CIDI includes a screening module and 40 sections that focus on diagnoses (22 sections), functioning (four sections), treatment (two sections), risk factors (four sections), socio-demographic correlates (seven sections), and methodological factors (two sections). Innovations compared to earlier versions of the CIDI include expansion of the diagnostic sections, a focus on 12-month as well as lifetime disorders in the same interview, detailed assessment of clinical severity, and inclusion of information on treatment, risk factors, and consequences. A computer-assisted version of the interview is available along with a direct data entry software system that can be used to keypunch responses to the paper-and-pencil version of the interview. Computer programs that generate diagnoses are also available based on both ICD-10 and DSM-IV criteria. Elaborate CD-ROM-based training materials are available to teach interviewers how to administer the interview as well as to teach supervisors how to monitor the quality of data collection.

4,232 citations

Journal ArticleDOI
02 Jun 2004-JAMA
TL;DR: Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases and careful consideration needs to be given to the value of treating some mild cases, especially those at risk for progressing to more serious disorders.
Abstract: Context Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. Objective To estimate prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. Design, Setting, and Participants Face-to-face household surveys of 60463 community adults conducted from 2001-2003 in 14 countries in the Americas, Europe, the Middle East, Africa, and Asia. Main Outcome Measures The DSM-IV disorders, severity, and treatment were assessed with the WMH version of the WHO Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay-administered psychiatric diagnostic interview. Results The prevalence of having any WMH-CIDI/DSM-IV disorder in the prior year varied widely, from 4.3% in Shanghai to 26.4% in the United States, with an interquartile range (IQR) of 9.1%-16.9%. Between 33.1% (Colombia) and 80.9% (Nigeria) of 12-month cases were mild (IQR, 40.2%-53.3%). Serious disorders were associated with substantial role disability. Although disorder severity was correlated with probability of treatment in almost all countries, 35.5%.to 50.3% of serious cases in developed countries and 76.3% to 85.4% in less-developed countries received no treatment in the 12 months before the interview. Due to the high prevalence of mild and subthreshold cases, the number of those who received treatment far exceeds the number of untreated serious cases in every country. Conclusions Reallocation of treatment resources could substantially decrease the problem of unmet need for treatment of mental disorders among serious cases. Structural barriers exist to this reallocation. Careful consideration needs to be given to the value of treating some mild cases,. especially those at risk for progressing to more serious disorders.

3,079 citations

Journal ArticleDOI
TL;DR: The CIDI is a comprehensive and fully standardized diagnostic interview designed for assessing mental disorders according to the definitions of the Diagnostic Criteria for Research of ICD-10 and DSM-III-R and was found to be appropriate for use in different kinds of settings and countries.

2,284 citations

Journal ArticleDOI
TL;DR: Results are quite encouraging in suggesting that diagnostic classifications made in the full CIDI can be reproduced with excellent accuracy with the C IDI‐SF scales, however, independent verification of this reproduction accuracy is needed in a data set other than the one in which the CIDi‐SF was developed.
Abstract: Data are reported on a series of short-form (SF) screening scales of DSM-III-R psychiatric disorders developed from the World Health Organization's Composite International Diagnostic Interview (CIDI). A multi-step procedure was used to generate CIDI-SF screening scales for each of eight DSM disorders from the US National Comorbidity Survey (NCS). This procedure began with the subsample of respondents who endorsed the CIDI diagnostic stem question for a given disorder and then used a series of stepwise regression analyses to select a subset of screening questions to maximize reproduction of the full CIDI diagnosis. A small number of screening questions, between three and eight for each disorder, was found to account for the significant associations between symptom ratings and CIDI diagnoses. Summary scales made up of these symptom questions correctly classify between 77% and 100% of CIDI cases and between 94% and 99% of CIDI non-cases in the NCS depending on the diagnosis. Overall classification accuracy ranged from a low of 93% for major depressive episode to a high of over 99% for generalized anxiety disorder. Pilot testing in a nationally representative telephone survey found that the full set of CIDI-SF scales can be administered in an average of seven minutes compared to over an hour for the full CIDI. The results are quite encouraging in suggesting that diagnostic classifications made in the full CIDI can be reproduced with excellent accuracy with the CIDI-SF scales. Independent verification of this reproduction accuracy, however, is needed in a data set other than the one in which the CIDI-SF was developed. Copyright © 1998 Whurr Publishers Ltd.

2,044 citations

Journal ArticleDOI
TL;DR: The high rate of not consulting among those with disability and comorbidity is an important public health problem as Australia has a universal health insurance scheme and the barriers to effective care must be patient knowledge and physician competence.
Abstract: Background Health planning should be based on data about prevalence, disability and services used. Aims To determine the prevalence of ICD-10 disorders and associated comorbidity, disability and service utilisation. Method We surveyed a national probability sample of Australian households using the Composite International Diagnostic Interview and other measures. Results The sample size was 10 641 adults, response rate 78%. Close to 23% reported at least one disorder in the past 12 months and 14% a current disorder. Comorbidity was associated with disability and service use. Only 35% of people with a mental disorder in the 12 months prior to the survey had consulted for a mental problem during that year, and most had seen a general practitioner. Only half of those who were disabled or had multiple comorbidity had consulted and of those who had not, more than half said they did not need treatment. Conclusions The high rate of not consulting among those with disability and comorbidity is an important public health problem. As Australia has a universal health insurance scheme, the barriers to effective care must be patient knowledge and physician competence.

982 citations

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Clinical characteristics play an important role in perceiving barriers to mental health care.