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Awareness of treatment history in family and friends, and mental health care seeking propensity



Many adults suffering from mental disorders never receive the care they need. The role of family and friends in overcoming mental health treatment barriers is poorly understood. We investigated the association between awareness of lifetime mental health treatment history in one’s family or friends, and likelihood of having recently received mental health care for oneself.


Using Canadian Community Health Survey 2012—Mental Health data, we defined care seekers as individuals who talked about mental health issues to at least one health professional in the past 12 months. Seekers were matched to non-seekers based on estimated care seeking propensity, and 1933 matched pairs were created. Reported awareness of lifetime treatment history in family and friends was compared between seekers and non-seekers.


There were no differences in the distribution of any confounder of interest between seekers and non-seekers. 73% of seekers were aware of treatment history in family or friends, compared to only 56% of non-seekers (RR 1.3; 95% CI 1.2, 1.3). Awareness of treatment history in family members had nearly identical associations with care seeking as awareness of treatment history in friends.


We have found a social clustering of mental health care seeking behavior; individuals who were aware of lifetime treatment history in family or friends were more likely to have recently sought care for themselves. These novel results are consistent with a social learning model of care seeking behavior, and could inform efforts to bridge the current mental health treatment gap.

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  1. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C et al (2012) Disability-adjusted life years (dalys) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380(9859):2197–2223

    Article  PubMed  Google Scholar 

  2. Smetanin P, Stiff D, Briante C, Adair C, Ahmad S, Khan M (2011) The life and economic impact of major mental illness in canada: 2011 to 2041, Risk Analytica, on behalf of the Mental Health Commission of Canada

  3. Center for Behavioral Health Statistics and Quality (2015) Behavioral health trends in the united states: results from the 2014 national survey on drug use and health

  4. Deverill C, King M (2009) Common mental disorders. In: McManus S et al (eds) Adult psychiatric morbidity in England, 2007: results of a household survey. NHS Information Centre, United Kingdom, pp 25–51

  5. Australian Bureau of Statistics (2008) National survey of mental health and wellbeing: summary of results

  6. Mojtabai R, Olfson M, Mechanic D (2002) Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry 59(1):77–84

    Article  PubMed  Google Scholar 

  7. Bebbington P, Meltzer H, Brugha T, Farrell M, Jenkins R, Ceresa C et al (2003) Unequal access and unmet need: Neurotic disorders and the use of primary care services. Int Rev Psychiatry 15(1–2):115–122

    Article  CAS  PubMed  Google Scholar 

  8. Andrews G, Sanderson K, Corry J, Lapsley HM (2000) Using epidemiological data to model efficiency in reducing the burden of depression. J Ment Health Policy Econ 3(4):175–186

    Article  PubMed  Google Scholar 

  9. Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P et al (2016) Scaling-up treatment of depression and anxiety: a global return on investment analysis. Lancet Psychiatry 3(5):415–424

    Article  PubMed  Google Scholar 

  10. Kendler KS (1995) Is seeking treatment for depression predicted by a history of depression in relatives? Implications for family studies of affective disorder. Psychol Med 25(4):807–814

    Article  CAS  PubMed  Google Scholar 

  11. Bandura A (1977) Social learning theoryNew York. General Learning Press, New York

    Google Scholar 

  12. Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B (2000) Attitudes towards people with depression: Effects on the public’s help-seeking and outcome when experiencing common psychiatric symptoms. Aust N Z J Psychiatry 34(4):612–618

    Article  CAS  PubMed  Google Scholar 

  13. Jorm AF, Christensen H, Medway J, Korten AE, Jacomb PA, Rodgers B (2000) Public belief systems about the helpfulness of interventions for depression: Associations with history of depression and professional help-seeking. Soc Psychiatry Psychiatr Epidemiol 35(5):211–219

    Article  CAS  PubMed  Google Scholar 

  14. Bell RA, Franks P, Duberstein PR, Epstein RM, Feldman MD, Fernandez Y, Garcia E et al (2011) Suffering in silence: reasons for not disclosing depression in primary care. Ann Fam Med 9(5):439–446

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hansen MC, Cabassa LJ (2012) Pathways to depression care: Help-seeking experiences of low-income latinos with diabetes and depression. J Immigr Minor Health 14(6):1097–1106

    Article  PubMed  Google Scholar 

  16. Rickwood DJ, Mazzer KR, Telford NR (2015) Social influences on seeking help from mental health services, in-person and online, during adolescence and young adulthood. BMC Psychiatry 15(40). doi:10.1186/s12888-015-0429-6

  17. Fikretoglu D, Liu A (2015) Perceived barriers to mental health treatment among individuals with a past-year disorder onset: Findings from a canadian population health survey. Soc Psychiatry Psychiatr Epidemiol 50(5):739–746

    Article  PubMed  Google Scholar 

  18. Vogel DL, Wester SR, Larson LM (2007) Avoidance of counseling: psychological factors that inhibit seeking help. J Couns Dev 85(4):410–422

    Article  Google Scholar 

  19. Vogel DL, Wester SR, Wei M, Boysen GA (2005) The role of outcome expectations and attitudes on decisions to seek professional help. J Couns Psychol 52(4):459–470

    Article  Google Scholar 

  20. Rickwood DJ, Braitwaite VA (1994) Social-psychological factors affecting help-seeking for emotional problems. Soc Sci Med 39(4):563–572

    Article  CAS  PubMed  Google Scholar 

  21. Statistics Canada (2013) Canadian community health survey—mental health

  22. Kessler RC, Ustün TB (2004) The world mental health (wmh) survey initiative version of the world health organization (who) composite international diagnostic interview (cidi). Int J Methods Psychiatr Res 13(2):93–121

    Article  PubMed  Google Scholar 

  23. Statistics Canada (2014) Canadian community health survey mental health: public use microdata file—derived variable (dv) specifications.

  24. Haro JM, Arbabzadeh-Bouchez S, Brugha TS, De Girolamo G, Guyer ME, Jin R et al (2006) Concordance of the composite international diagnostic interview version 3.0 (cidi 3.0) with standardized clinical assessments in the who mental health surveys. Int J Methods Psychiatr Res 15(4):167–180

    Article  PubMed  Google Scholar 

  25. Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL et al (2002) Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 32(6):959–976

    Article  CAS  PubMed  Google Scholar 

  26. Slade T, Grove R, Burgess P (2011) Kessler psychological distress scale: normative data from the 2007 australian national survey of mental health and wellbeing. Aust N Z J Psychiatry 45(4):308–316

    Article  PubMed  Google Scholar 

  27. Stuart EA (2010) Matching methods for causal inference: a review and a look forward. Stat Sci 25(1):1–21

    Article  PubMed  PubMed Central  Google Scholar 

  28. Statacorp (2009) Stata statistical software: release 11, StataCorp LP, College Station

    Google Scholar 

  29. Prokofyeva E, Martins SS, Younes N, Surkan PJ, Melchior M (2013) The role of family history in mental health service utilization for major depression. J Affect Disord 151(2):461–466

    Article  PubMed  Google Scholar 

  30. Nowak SA, Parker AM (2014) Social network effects of nonlifesaving early-stage breast cancer detection on mammography rates. Am J Public Health 104(12):2439–2444

    Article  PubMed  PubMed Central  Google Scholar 

  31. Rao N, Mobius MM, Rosenblat T (2007) Social networks and vaccination decisions. FRB og Boston Working Paper No 07–12

  32. Rosen LJ, Noach MB, Winickoff JP, Hovell MF (2012) Parental smoking cessation to protect young children: a systematic review and meta-analysis. Pediatrics 129(1):141–152

    Article  PubMed  Google Scholar 

  33. Morgan PJ, Lubans DR, Callister R, Okely AD, Burrows TL, Fletcher R et al (2011) The ‘healthy dads, healthy kids’ randomized controlled trial: Efficacy of a healthy lifestyle program for overweight fathers and their children. Int J Obes (Lond) 35(3):436–447

    Article  CAS  Google Scholar 

  34. Macdonald EM, Hayes RL, Baglioni AJ Jr (2000) The quantity and quality of the social networks of young people with early psychosis compared with closely matched controls. Schizophr Res 46(1):25–30

    Article  CAS  PubMed  Google Scholar 

  35. Kang SH, Wallace NT, Hyun JK, Morris A, Coffman J, Bloom JR (2007) Social networks and their relationship to mental health service use and expenditures among medicaid beneficiaries. Psychiatr Serv 58(5):689–695

    Article  PubMed  Google Scholar 

  36. Carpentier N, White D (2002) Cohesion of the primary social network and sustained service use before the first psychiatric hospitalization. J Behav Health Serv Res 29(4):404–418

    Article  PubMed  Google Scholar 

  37. Leng G, Adan RA, Belot M, Brunstrom JM, De Graaf K, Dickson SL et al (2016) The determinants of food choice. Proc Nutr Soc. doi:10.1017/s002966511600286x

  38. Kelly SA, Pomp D (2013) Genetic determinants of voluntary exercise. Trends Genet 29(6):348–357

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Sullivan PF, Neale MC, Kendler KS (2000) Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry 157(10):1552–1562

    Article  CAS  PubMed  Google Scholar 

  40. Canadian Task Force on Preventive Medicine, Joffres M, Jaramillo A, Dickinson J, Lewin G, Pottie K et al (2013) Recommendations of screening for depression in adults. CMAJ 185(9):775–782

    Article  Google Scholar 

  41. Rubin DB (1997) Estimating causal effects from large data sets using propensity scores. Ann Intern Med 127(8 Pt 2):757–763

    Article  CAS  PubMed  Google Scholar 

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The authors thank Gabrielle Galley, Dylan Johnson, Nathalie MacKinnon, Kiyuri Naicker, and Ewa Sucha for their methodological advice.

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Correspondence to Ian Colman.

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This research was funded in part by financial support from the Canada Research Chairs program for Ian Colman.

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The authors have no conflict of interest to declare.

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Thériault, F.L., Colman, I. Awareness of treatment history in family and friends, and mental health care seeking propensity. Soc Psychiatry Psychiatr Epidemiol 52, 485–492 (2017).

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