Skip to main content

Advertisement

Log in

Perception of Unmet Need after Seeking Treatment for a Past Year Major Depressive Episode: Results from the 2018 National Survey of Drug Use and Health

  • Original Paper
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

Depression, a leading cause of disability and mortality world-wide that one in five U.S. adults are estimated to experience in their lifetime, presents special complications in treatment. While it is well-recognized that there are several barriers to even obtaining treatment for depression, once an individual obtains treatment they may not receive the type of care that they need. In order to examine common factors of those who experienced an unmet treatment need for depression despite seeking mental health treatment, we examined data from the 2018 National Survey of Drug Use and Health (NSDUH). We cross-sectionally compared two groups of individuals who both met criteria for a past year Major Depressive Episode (MDE) and sought mental health treatment, however one group reported an unmet treatment need and the other did not. Results indicate a variety of personal identity and social factors associated with perceiving an unmet treatment need, including age, race/ethnicity, sexual attraction, marital status, poverty level, health insurance, substance misuse, global health, and role impairment. This study contributes to the literature by providing further support for disparities in depression treatment at the consumer, provider, and systemic levels that have downstream effects for health equity policy and public health promotion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Data Availability

The 2018 National Survey of Drug use and Health is a data set available for public use from the Center for Behavioral Health Statistics and Quality.

Code Availability

Not applicable.

References

  1. Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res. 2020;126:134–40.

    Article  PubMed  Google Scholar 

  2. Lépine JP, Briley M. The increasing burden of depression. Neuropsychiatr Dis Treat. 2011;7:3–7.

    PubMed  PubMed Central  Google Scholar 

  3. Weinberger AH, Gbedemah M, Martinez AM, Nash D, Galea S, Goodwin RD. Trends in depression prevalence in the USA from 2005 to 2015: widening disparities in vulnerable groups. Psychol Med. 2018;48:1308–15.

    Article  CAS  PubMed  Google Scholar 

  4. Greenberg PE, Fournier AA, Sisitsky T, Pike CT, Kessler RC. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry. 2015;76:155–62.

    Article  PubMed  Google Scholar 

  5. Ali MM, Lackey S, Mutter R, McKeon R. The relationship between perceived unmet mental health care needs and suicidal ideation and attempt. Adm Policy Ment Heal Ment Heal Serv Res. 2018;45:709–15.

    Article  Google Scholar 

  6. Shippee ND, Call KT, Weber W, Beebe TJ. Depression, access barriers, and their combined associations with unmet health needs among publicly insured individuals in Minnesota. Soc Ment Health. 2012;2:85–98.

    Article  Google Scholar 

  7. Gulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry. 2012;12:81.

  8. Andrade LH, Alonso J, Mneimneh Z, et al. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychol Med. 2014;44:1303–17.

    Article  CAS  PubMed  Google Scholar 

  9. Grella CE, Cochran SD, Greenwell L, Mays VM. Effects of sexual orientation and gender on perceived need for treatment by persons with and without mental disorders. Psychiatr Serv. 2011;62:404–10.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Breslau J, Stein BD, Burns RM, et al. Examining contradictory evidence on racial/ethnic differences in perceived need for behavioral health treatment. Int J Methods Psychiatr Res. 2018;27:1–8.

    Article  Google Scholar 

  11. Deen T, Bridges A. Depression literacy : rates and relation to perceived need and mental health service utilization in a rural American sample. Rural Remote Health. 2011;11:1–13.

  12. van Beljouw IMJ, Verhaak PFM, Cuijpers P, van Marwijk HWJ, Penninx BWJH. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study. BMC Psychiatry. 2010;10:86.

  13. Goodman LA, Pugach M, Skolnik A, Smith L. Poverty and mental health practice: within and beyond the 50-minute hour. J ClinPsychol. 2013;69:182–90.

    Google Scholar 

  14. Bonvicini KA. LGBT healthcare disparities: what progress have we made? Patient Educ Couns. 2017;100:2357–61.

    Article  PubMed  Google Scholar 

  15. Hides L, Quinn C, Stoyanov S, Kavanagh D, Baker A. Psychological interventions for co-occurring depression and substance use disorders. Cochrane Database Syst Rev. 2019;1–67.

  16. Shapero BG, Mischoulon D, Cusin C (eds): The Massachusetts General Hospital Guide to depression. Cham: Springer Nature Switzerland AG, 2019.

  17. Üstün TB, Ayuso-Mateos JL, Chatterji S, Mathers C, Murray CJL. Global burden of depressive disorders in the year 2000. Br J Psychiatry. 2004;184:386–92.

    Article  PubMed  Google Scholar 

  18. Drakes WA. Major depressive disorder in the African American population. J Natl Med Assoc. 2012;104:463–4.

    Article  PubMed  Google Scholar 

  19. Center for Behavioral Health Statistics and Quality. Survey on Drug Use and Health Final Analytic File Codebook. Rockville: Substance Abuse and Mental Health Services Administration; 2019.

    Google Scholar 

  20. Doblyte S, Jiménez-Mejías E. Understanding help-seeking behavior in depression: a qualitative synthesis of patients’ experiences. Qual Health Res. 2017;27:100–13.

    Article  PubMed  Google Scholar 

  21. Castonguay J, Filer CR, Pitts MJ. Seeking help for depression: applying the health belief model to illness narratives. South Commun J. 2016;81:289–303.

    Article  Google Scholar 

  22. Eisenberg D, Golberstein E, Gollust SE, Eisenberg D, Golberstein E, Gollust SE. Help-Seeking and Access to Mental Health Care in a University Student Population. 2007;45:594–601.

    Google Scholar 

  23. Orom H, Schofield E, Kiviniemi MT, et al. Low health literacy and health information avoidance but not satisficing help explain “don’t know” responses to questions assessing perceived risk. Med Decis Mak. 2018;38:1006–17.

    Article  Google Scholar 

  24. Sheehan DV. The anxiety disease. New York: Charles Scribner and Sons. 1983.

  25. IBM Corp. IBM SPSS statistics for windows, version 24. IBM Corp. 2016.

  26. R Core Team: R: A language and environment for statistical computing. R Foundation for Statistical Computing. 2019.

  27. Lumley T. Survey: analysis of complex survey samples. R package version 3. 2019:35–1.

  28. VanderWeele TJ, Mathur MB. Some desirable properties of the Bonferroni correction: is the Bonferroni correction really so bad? Am J Epidemiol. 2019;188:617–8.

    Article  PubMed  Google Scholar 

  29. McGuire TG, Miranda J. New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Aff. 2008;27:393–403.

    Article  Google Scholar 

  30. Ishikawa RZ, Cardemil EV, Falmagne RJ. Help seeking and help receiving for emotional distress among latino men and women. Qual Health Res. 2010;20:1558–72.

    Article  PubMed  Google Scholar 

  31. Cochran SD, Sullivan JG, Mays VM. Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the united states researchers have shown that some forms of mental disorders, particularly. J Consult Clin Psychol. 2003;71:53–61.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Grella CE, Greenwell L, Mays VM, Cochran SD. Influence of gender, sexual orientation, and need on treatment utilization for substance use and mental disorders: findings from the California quality of life survey. BMC Psychiatry. 2009;9:1–10.

    Article  Google Scholar 

  33. Santiago CD, Kaltman S, Miranda J. Poverty and mental health: how do low-income adults and children fare in psychotherapy? J Clin Psychol. 2013;69:115–26.

    Article  PubMed  Google Scholar 

  34. Marshall EG. Do young adults have unmet healthcare needs? J Adolesc Heal. 2011;49:490–7.

    Article  Google Scholar 

  35. Wang N, Ouedraogo Y, Chu J, Liu Y, Wang K, Xie X. Variable reduction for past year alcohol and drug use in unmet need for mental health services among US adults. J Affect Disord. 2019;256:110–6.

    Article  PubMed  Google Scholar 

  36. Olfson M, Liu SM, Grant BF, Blanco C. Influence of comorbid mental disorders on time to seeking treatment for major depressive disorder. Med Care. 2012;50:227–32.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Chen L-Y, Crum RM, Martins SS, Kaufmann CN, Strain EC, Mojtabai R. Service use and barriers to mental health care among adults with major depression and comorbid substance dependence. Psychiatr Serv. 2013;64:863–70.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Mojtabai R, Chen LY, Kaufmann CN, Crum RM. Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders. J Subst Abuse Treat. 2014;46:268–73.

    Article  PubMed  Google Scholar 

  39. Worley MJ, Trim RS, Roesch SC, Mrnak-Meyer J, Tate SR, Brown SA. Comorbid depression and substance use disorder: longitudinal associations between symptoms in a controlled trial. J Subst Abuse Treat. 2012;43:291–302.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Bergfeld IO, Mantione M, Figee M, Schuurman PR, Lok A, Denys D. Treatment-resistant depression and suicidality. J Affect Disord. 2018;235:362–7.

    Article  CAS  PubMed  Google Scholar 

  41. Budge SL, Adelson JL, Howard KAS. Anxiety and depression in transgender individuals: the roles of transition status, loss, social support, and coping. J Consult Clin Psychol. 2013;81:545–57.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Ethics declarations

All authors declare that they have no conflicts of interest to disclose. The 2018 National Survey of Drug use and Health is a data set available for public use from the Center for Behavioral Health Statistics and Quality. All participants gave an informed consent for research, and data collection was performed in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflicts of Interest/Competing Interests

Not applicable.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hunt, A.D., Adams, L.M. Perception of Unmet Need after Seeking Treatment for a Past Year Major Depressive Episode: Results from the 2018 National Survey of Drug Use and Health. Psychiatr Q 92, 1271–1281 (2021). https://doi.org/10.1007/s11126-021-09913-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-021-09913-y

Keywords

Navigation