Unmet Needs for Mental Health Care and Its Implication for Health Education in Canada

  • Park, Jung-Wee (School of Public Health, Lakehead University) ;
  • Nelson Connie H. (School of Social Work, Lakehead University, CANADA)
  • Published : 2005.09.30

Abstract

Objectives: Individuals' self-reported unmet needs are an important indicator of heath care of their society. Using data from the Canadian Community Health Survey (CCHS) Cycle 1.2, we examine unmet needs for mental health care in Canada and discuss its implications to health education. Results: The most frequently reported reason for unmet needs was barriers to acceptability issues, which stem primarily from lack of knowledge of mental health, negative attitudes towards mental disorder, and mistrust of mental health professionals. Unmet needs for mental health care appeared an especially serious issue among the young. Also, individuals who reported unmet needs tended to have some ill health behavior such as illicit drug use that could be their coping mechanism. On the other hand, emotional and informational support factors have shown an important mitigating effect on unmet needs. Conclusions: These findings of unmet needs pose a major challenge to health education. To effectively address unmet mental health care needs, it is recommended that the focus of relevant policies and programs should be on enhancing a multi-level mental health education strategy including efforts on individual, environmental and professional level education.

Keywords

References

  1. American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC: American Psychiatric Association
  2. Andrade, L., Caraveo-Anduaga, J,J., Berglund, P., Bijl, R., Kessler, R.C., Demler, O., Walters, E. et al. 2000. Cross national comparisons of the prevalences and correlates of mental disorders. Bulletin of World Health Organizations 78(4):413-426
  3. D'Augelli. 1983. Services for mental health, health care, and the elderly. In J.K. Whittaker and J. Garbarino (Eds.) Social support networks: Informal helping in the human services(pp. 73-106). New York: Aldine Publishing Co
  4. Bailis, D.S., Alexander Segall, A. and Chipperfield, J.G. 2003. Two views of self-rated general health status. Social Science & Medicine 56(2):203-217 https://doi.org/10.1016/S0277-9536(02)00020-5
  5. Baruch, G., Gerber, A. and Fearon, P. 1998. Adolescents who drop out of psychotherapy at a community-based psychotherapy center. British Journal of Medical Psychology, 71(3):233-245 https://doi.org/10.1111/j.2044-8341.1998.tb00988.x
  6. Beland, Y., Dufour, J. and Gravel, R. 2001. Sample design of the Canadian mental health survey. Proceedings of the Survey Methods Section Vancouver, 93-98
  7. Beland, Y. 2002. Canadian community health survey - methodological overview. Health Report 13(3):9-14
  8. Canadian Mental Health Association. 2004. Briefs and Submissions. Retrieved July 1, 2005 from: http://www.cmha.ca/bins
  9. Coburn, D. and Eakin, J.M. 1993. The sociology of health in Canada: First impressions. Health and Canadian Society 1(1):83-110
  10. Cooper-Patrick, L., Powe, N.R., Jenckes, M.W. et al. 1997. Identification of patient attitudes and preferences regarding treatment of depression. Journal of General Internal Medicine 12 :431-8 https://doi.org/10.1046/j.1525-1497.1997.00075.x
  11. Corin, E. 1994. The social and cultural matrix of health and disease. In Evans RG, Barer, ML, Marmor TR, eds( pp. 93-132) Why Are Some People Healthy and Others Not? Hawthorne, New York: Aldine de Gruyter
  12. Corrigan, P.W. and Penn, D.L. 1999. Lessons from social psychology on discrediting psychiatric stigma. American Psychologist 54 :765-776 https://doi.org/10.1037/0003-066X.54.9.765
  13. Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J.P. et al. 2004. Prevalence, severity, and unmet need for treatment of mental disorders in the world health organization world mental health surveys. Journal of the American Medical Association 291(21):2581-2590 https://doi.org/10.1001/jama.291.21.2581
  14. Gold, M. 1998. Beyond coverage and supply: Measuring access to healthcare in today's market. Health Services Research 33(Part II):625-652
  15. Fisher, C.S., Jackson, R.M., Stueve, C.A., et al. 1977. Networks and places: Social relations in the urban setting. New York: Free Press
  16. Gottlieb, B.H. 1976. Preventive interventions involving social networks and social support. In B.H. Gottlieb (Ed), Social networks and social support. Beverly Hills, CA: Sage
  17. Health Canada. 1994. Strategies for population health: Investing in the health of Canadians. Ottawa: Minister of Supply and Services Canada
  18. House, J.S., Landis, K.R. and Umberson, D. 1988. Social relationships and health. Science. 241(July 29):540-45
  19. Katz, S.J., Kessler, R.C., Lin, E. and Wells, K.B. 1998. Medication management of depression in the United States and Ontario. Journal of General Internal Medicine 13: 77-85 https://doi.org/10.1046/j.1525-1497.1998.00022.x
  20. Kessler, R.C., Berglund, P.A., Bruce, M.L., Koch, J.R., Laska, E.M., Leaf, P.J. et al. 2001. The prevalence and correlates of untreated serious mental illness. Health Services Research 36(6):987-1007
  21. Lin, E. and Parikh, S.V. 1999. Sociodemographic, clinical, and attitudinal characteristics of the untreated depressed in Ontario. Journal of Affective Disorders 53(2): 153-162 https://doi.org/10.1016/S0165-0327(98)00116-5
  22. Martikainen, P., Aromaa, A., Heliovaara, M., Klaukka, T., Knekt, P., Maatela, J. et al. 1999. Reliability of perceived health by sex and age, Social Science & Medicine 48(8): 1117-1122 https://doi.org/10.1016/S0277-9536(98)00416-X
  23. Millar, J.S. and Hull, C. 1997. Measuring human wellness. Social Indicators Research 40:147-158 https://doi.org/10.1023/A:1006803426777
  24. Rao, J.N.K., Wu, C.F.J. and Yue, K. 1992. Some recent work on resampling methods for complex surveys. Survey Methodology 18(2):209-217
  25. Raphael, D. 2004. Introduction to the social determinants of health. In D. Raphael(Ed), Social Determinants of Health: Canadian Perspectives(pp. 1-18). Toronto: Canadian Scholars' Press Inc
  26. Reed, J.E., Burdine, J.N. and Felix, M. 2003. Aggregate health status: A Benchmark index for community health. Journal of Medical Systems 27(2):177-189 https://doi.org/10.1023/A:1021817128603
  27. Rust, K.F. and Rao, J.N.K. 1996. Variance estimation for complex surveys using replication techniques. Statistical Methods in Medical Research 5:281-310
  28. Standing Senate Committee on Social Affairs, Science and Technology, 2004. Mental Health, Mental Illness and Addiction: Issues and Options for Canada Ottawa: The Senate
  29. Statistics Canada. 2003. Canadian community health survey mental health and well-being. Retrieved from: http://www.statcan.ca/english/freepub/82-617-XIE/index.htm
  30. Statistics Canada. 2004. Definitions of mental disorders in the Canadian Community Health Survey: Mental Health and Well-being. Health Reports 15(supp): 49-63
  31. Statistics Canada. 2005. Labour Force Survey(LFS). Retrieved from: http://www.statcan.ca/english/sdds/3701.htm
  32. Sussman, L.K., Robins L.N. and Earls, F. 1987. Treatment-seeking for depression by black and white Americans. Social Science & Medicine 24:187-96 https://doi.org/10.1016/0277-9536(87)90046-3
  33. U.S. Department of Health and Human Services. 2001. Mental Health: A report of the Surgeon General Washington, D.C.: Department of Health and Human Services
  34. Wagenaar, D.B., Mickus, M.A., Gaumer, K.A., et al. 2002. Late-life depression and mental health services in primary care. Journal of Geriatric Psychiatry and Neurology 15(3):134-40 https://doi.org/10.1177/089198870201500304
  35. Warren, D.I. 1981. Helping Networks. Notre Dame, IN: University of Notre Dame Press
  36. Wrigley, S., Jackson, H., Judd, F. et al. 2005. Role of stigma and attitudes toward help-seeking from a general practitioner for mental health problems in a rural town. Australian and New Zealand Journal of Psychiatry 39(6):514-21 https://doi.org/10.1111/j.1440-1614.2005.01612.x
  37. Yeo, D., Mantel, H. and Liu, T.P. 1999. Bootstrap variance estimation for the national population health survey. American statistical association: Proceedings of the survey research methods section, Baltimore. USA