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.
KeywordsDepressive disorder Substance-related disorders Mental health services Utilization Unmet need
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
- Compas, B. E., Oppedisano, G., Connor, J. K., Hinden, B. R., Achenbach, T. M., & Hammen, C. (1997). Gender differences in depressive symptoms in adolescence: Comparison of national samples of clinically referred and nonreferred youths. Journal of Consulting and Clinical Psychology, 65, 617–626.PubMedCrossRefGoogle Scholar
- Hirschfeld, R. M., Keller, M. B., Panico, S., Arons, B. S., Barlow, D., & Davidoff, F., et al. (1997). The national depressive and manic-depressive association consensus statement on the undertreatment of depression. Journal of the American Medical Association, 277, 333–340.PubMedCrossRefGoogle Scholar
- Kessler, R. (1986). Sex differences in the use of health services. In: S. McHugh & M. Vallis (Eds.), Illness behavior: A multidisciplinary model (pp. 135–148). New York: Plenum.Google Scholar
- Kessler, R. C., Olfson, M., & Berglund, P. A. (1998a). Patterns and predictors of treatment contact after first onset of psychiatric disorders. American Journal of Psychiatry, 155, 62–69.Google Scholar
- Kessler, R. C., Walters, E. E., & Forthofer, M. S. (1998b). Social consequences of psychiatric disorders, III: Probability of marital stability. American Journal of Psychiatry, 155, 1092–1096.Google Scholar
- Puig-Antich, J., Lukens, E., Davies, M., Goetz, D., Brennan-Quattrock, J., & Todak, G. (1985a). Psychosocial functioning in prepubertal major depressive disorders, I: Interpersonal relationships during the depressive episode. Archives of General Psychiatry, 42, 500–507.Google Scholar
- Puig-Antich, J., Lukens, E., Davies, M., Goetz, D., Brennan-Quattrock, J., & Todak, G. (1985b). Psychosocial functioning in prepubertal major depressive disorders. II. Interpersonal relationships after sustained recovery from the depressive episode. Archives of General Psychiatry, 42, 511–517.Google Scholar
- SAS Institute, Inc. (1999). SAS Statistical Software, version 8. Cary, NC: Author.Google Scholar
- Tanner, J. M. (1962). Growth at adolescence: With a general consideration of effects of hereditary and environmental factors upon growth and maturation from birth to maturity. Oxford, England: Blackwell Scientific Publications.Google Scholar