Subjective Unmet Need for Mental Health Services in Depressed Children Grown Up
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Limited attention has been devoted to characterizing unmet need for treatment among individuals with mental disorders. A longitudinal follow-up of depressed, anxious, and psychiatrically normal children into adulthood provided an opportunity to examine factors associated with subjective unmet need.
Respondents (n = 208) comprise a subsample of a cohort ascertained between 1977 and 1985 consisting of three subgroups: one with major depressive disorder (MDD), one with anxiety disorders but no MDD, and controls with no psychiatric disorder up to ascertainment. Psychiatric status was reassessed in adulthood using the SADS-LA by interviewers blind to childhood diagnoses. Best-estimate diagnoses describing participants’ lifetime clinical course were formulated by senior clinicians. Participants who completed SADS-LA interviews about themselves were invited to complete an additional interview about experiences with health care, including subjective unmet need for and barriers to mental health treatment.
About 37% of respondents reported lifetime histories of subjective unmet need for mental health services. Unmet need was associated with female gender and lifetime mood and substance dependence disorders. The most commonly cited barriers included attitudes toward treatment, not knowing where to obtain it, and financial concerns.
Subjective unmet need was common in this sample. Approaches to reducing it might include public health initiatives to foster more favorable attitudes toward treatment, increase knowledge of where to obtain it, and lower financial barriers.
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- Subjective Unmet Need for Mental Health Services in Depressed Children Grown Up
Administration and Policy in Mental Health and Mental Health Services Research
Volume 33, Issue 6 , pp 666-673
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers-Plenum Publishers
- Additional Links
- Depressive disorder
- Substance-related disorders
- Mental health services
- Unmet need
- Author Affiliations
- 1. Division of Clinical-Genetic Epidemiology, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
- 2. Division of Clinical-Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA
- 4. Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Ln., Rm. 3068, M.S. 9304, Bethesda, MD, 20892-9304, USA
- 3. Department of Neuroscience, University of Connecticut Health Science Center, Farmington, CT, USA