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Examining the Independent Effect of Social Support on Unmet Mental Healthcare Needs Among Canadians: Findings from a Population-Based Study

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Abstract

Although studies have identified social support as an important social determinant of health, few studies in Canada have actually examined the contributory role of social support in understanding access to mental healthcare services. The objective of this study was to examine the independent effect of social support on unmet mental healthcare needs among adult Canadians after taking into account predisposing, enabling, and need factors of the behavioural model of healthcare service use. This study uses data from the 2012 Canadian Community Health Survey-Mental Health. A sample of 3857 respondents aged 20 years and older with some form of perceived mental healthcare needs was analyzed using binary logistic regression with unmet mental healthcare needs as the outcome variable. The study found that of the 3857 respondents, close to a third (31.9 %) had unmet needs. Results from the binary logistic regression revealed that social support had a significant independent effect on unmet mental healthcare needs. For each one unit increase in social support, the odds of a respondent having unmet needs were predicted to decease by a factor of 10 % (AOR 0.90, p < .001, 95 % CI 0.89–0.92), net the effect of predisposing, enabling, and need factors. Other factors associated with having unmet mental health care needs include: younger age, income, suicidal ideation, anxiety disorder, and adverse childhood experience. It is important to develop mental healthcare policies and programs that are appropriate and meet the needs of individuals with mental health-related problems and who are without adequate social support.

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References

  • Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care. Health Services Research, 9(3), 208–220.

    Google Scholar 

  • Ammerman, R. T., Peugh, J. L., Teeters, A. R., Putnam, F. W., & Van Ginkel, J. B. (2014). Child maltreatment history and response to CBT Treatment in depressed mothers participating in home visiting. Journal of Interpersonal Violence. doi:10.1177/0886260514556769.

    Google Scholar 

  • Andersen, R. M. (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10.

    Article  Google Scholar 

  • Andersen, R., & Newman, J. F. (2005). Societal and individual determinants of medical care utilization in the United States. Milbank Quarterly, 83(4), 1–28.

    Article  Google Scholar 

  • Baiden, P., den Dunnen, W., Arku, G., & Mkandawire, P. (2014). The role of sense of community belonging on unmet health care needs in Ontario, Canada: Findings from the 2012 Canadian Community Health Survey. Journal of Public Health, 22(5), 467–478.

    Article  Google Scholar 

  • Baiden, P., Fallon, B., den Dunnen, W., & Boateng, G. O. (2015). The enduring effects of early childhood adversities and troubled sleep among Canadian adults: A population-based study. Sleep Medicine, 16(6), 760–767.

    Article  Google Scholar 

  • Berkman, L. F., & Krishna, A. (2014). Social network epidemiology. In L. F. Berkman, I. Kawachi, & M. M. Glymour (Eds.), Social epidemiology (pp. 234–289). New york, NY: Oxford University Press.

    Google Scholar 

  • Bradley, E. H., McGraw, S. A., Curry, L., Buckser, A., King, K. L., Kasl, S. V., et al. (2002). Expanding the Andersen model: The role of psychosocial factors in long-term care use. Health Services Research, 37(5), 1221–1242.

    Article  Google Scholar 

  • Bryant, T., Leaver, C., & Dunn, J. (2009). Unmet healthcare need, gender, and health inequalities in Canada. Health Policy, 91(1), 24–32.

    Article  Google Scholar 

  • Canada Health Act. (1984). Canada Health Act, RSC 1985, c C-6. http://canlii.ca/t/51w33. Accessed on March 18, 2014.

  • Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging, 21(1), 140–151.

    Article  Google Scholar 

  • Caron, J. (1996). The scale of social provisions: Their validation in Quebec. Sante Mentale Au Quebec, 21(2), 158–180.

    Article  Google Scholar 

  • Carr, W., & Wolfe, S. (1976). Unmet needs as sociomedical indicators. International Journal of Health Services, 6(3), 417–430.

    Article  Google Scholar 

  • Cavalieri, M. (2013). Geographical variation of unmet medical needs in Italy: A multivariate logistic regression analysis. International Journal of Health and Geography, 12(27), 1–11.

    Google Scholar 

  • Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7(3), 269–297.

    Article  Google Scholar 

  • Cohen, S., & Lemay, E. P. (2007). Why would social networks be linked to affect and health practices? Health Psychology, 26(4), 410–417.

    Article  Google Scholar 

  • Cohen, S., & Wills, T. A. (1985). Stress, social support and the buffering hypothesis. Pscyhological Bulletin, 98(2), 310–354.

    Article  Google Scholar 

  • Conn, K. M., Swanson, D., McQuaid, E., Douthit, K., & Fisher, S. G. (2015). The relationship between helplessness and the child’s asthma symptoms: The role of social support. Journal of Asthma, 52(2), 135–145.

    Article  Google Scholar 

  • Coomber, K., & King, R. M. (2012). Coping strategies and social support as predictors and mediators of eating disorder carer burden and psychological distress. Social Psychiatry and Psychiatric Epidemiology, 47(5), 789–796.

    Article  Google Scholar 

  • Cutrona, C. E. (1984). Social support and stress in the transition to parenthood. Journal of Abnormal Psychology, 93(4), 378–390.

    Article  Google Scholar 

  • Cutrona, S., & Russell, D. (1990). Type of social support and specific stress: Toward a theory of optimal matching. In B. R. Sarason, I. G. Sarason, & G. R. Pierce (Eds.), Social support: An interactional view (pp. 319–366). New York: Wiley.

    Google Scholar 

  • Davis, L., & Brekke, J. (2014). Social support and functional outcome in severe mental illness: The mediating role of proactive coping. Psychiatry Research, 215(1), 39–45.

    Article  Google Scholar 

  • Dickens, C. M., McGowan, L., Percival, C., Douglas, J., Tomenson, B., & Cotter, L., et al. (2004). Lack of a close confidant, but not depression, predicts further cardiac events after myocardial infarction. Heart (British Cardiac Society), 90(5), 518–522.

    Article  Google Scholar 

  • Distelberg, B., & Taylor, S. (2013). The roles of social support and family resilience in accessing healthcare and employment resources among families living in traditional public housing communities. Child & Family Social Work, 20(4), 494–506.

    Article  Google Scholar 

  • Eskelinen, M., Korhonen, R., Selander, T., & Ollonen, P. (2015). Suicidal ideation versus hopelessness/helplessness in healthy individuals and in patients with benign breast disease and breast cancer: A prospective case–control study in Finland. Anticancer Research, 35(6), 3543–3551.

    Google Scholar 

  • Fielding, A. H., & Bell, J. F. (1997). A review of methods for the assessment of prediction errors in conservation presence/absence models. Environmental Conservation, 24(01), 38–49.

    Article  Google Scholar 

  • Fiori, K. L., & Consedine, N. S. (2013). Positive and negative social exchanges and mental health across the transition to college loneliness as a mediator. Journal of Social and Personal Relationships, 30(7), 920–941.

    Article  Google Scholar 

  • Fleury, M., Grenier, G., Bamvita, J., Tremblay, J., Schmitz, N., & Caron, J. (2013). Predictors of quality of life in a longitudinal study of users with severe mental disorders. Health and Quality of Life Outcomes, 11(92), 1–12.

    Google Scholar 

  • Gallagher, M., Prinstein, M. J., Simon, V., & Spirito, A. (2014). Social anxiety symptoms and suicidal ideation in a clinical sample of early adolescents: Examining loneliness and social support as longitudinal mediators. Journal of Abnormal Child Psychology, 42(6), 871–883.

    Article  Google Scholar 

  • Gerich, J. (2014). Effects of social networks on health from a stress theoretical perspective. Social Indicators Research, 118(1), 349–364.

    Article  Google Scholar 

  • Granovetter, M. S. (1973). The strength of weak ties. American Journal of Sociology, 78(6), 1360–1380.

    Article  Google Scholar 

  • Hansen, M. C., & Aranda, M. P. (2012). Sociocultural influences on mental health service use by Latino older adults for emotional distress: Exploring the mediating and moderating role of informal social support. Social Science and Medicine, 75(12), 2134–2142.

    Article  Google Scholar 

  • Hawkley, L. C., Thisted, R. A., Masi, C. M., & Cacioppo, J. T. (2010). Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychology and Aging, 25(1), 132–141.

    Article  Google Scholar 

  • Hewitt, B., Turrell, G., & Giskes, K. (2012). Marital loss, mental health and the role of perceived social support: Findings from six waves of an Australian population based panel study. Journal of Epidemiology and Community Health, 66(4), 308–314.

    Article  Google Scholar 

  • Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237.

    Article  Google Scholar 

  • Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression (2nd ed.). New York: Wiley.

    Book  Google Scholar 

  • House, J. S., & Kahn, R. L. (1985). Measures and concepts of social support. In S. Cohen & S. L. Syme (Eds.), Social support and health (pp. 83–108). New York: Academic Press.

    Google Scholar 

  • Huurre, T., Eerola, M., Rahkonen, O., & Aro, H. (2007). Does social support affect the relationship between socioeconomic status and depression? A longitudinal study from adolescence to adulthood. Journal of Affective Disorders, 100(1), 55–64.

    Article  Google Scholar 

  • Ikeda, A., & Kawachi, I. (2010). Social networks and health. In A. Steptoe, et al. (Eds.), Handbook of behavioral medicine (pp. 237–261). New York, NY: Springer.

    Chapter  Google Scholar 

  • Ilse, B., Prell, T., Walther, M., Hartung, V., Penzlin, S., Tietz, F., et al. (2015). Relationship between disease severity, social support and health-related quality of life in patients with amyotrophic lateral sclerosis. Social Indicators Research, 120(3), 871–882.

    Article  Google Scholar 

  • Kahn, R. L., & Antonucci, T. C. (1980). Convoys over the life course: Attachment, roles, and social support. In P. B. Baltes & O. Brim (Eds.), Life-span development and behavior (Vol. 3). New York, NY: Academic Press.

    Google Scholar 

  • Kang, J. (2012). Pathways from social support to service use among caregivers at risk of child maltreatment. Children and Youth Services Review, 34(5), 933–939.

    Article  Google Scholar 

  • Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health. Journal of Urban Health, 78(3), 458–467.

    Article  Google Scholar 

  • Kong, F., & You, X. (2013). Loneliness and self-esteem as mediators between social support and life satisfaction in late adolescence. Social Indicators Research, 110(1), 271–279.

    Article  Google Scholar 

  • Kunst, M., Bogaerts, S., & Winkel, F. W. (2010). Domestic violence and mental health in a dutch community sample: The adverse role of loneliness. Journal of Community & Applied Social Psychology, 20(5), 419–425.

    Article  Google Scholar 

  • Langeland, E., & Wahl, A. K. (2009). The impact of social support on mental health service users’ sense of coherence: A longitudinal panel survey. International Journal of Nursing Studies, 46(6), 830–837.

    Article  Google Scholar 

  • LaRocca, M. A., & Scogin, F. R. (2015). The effect of social support on quality of life in older adults receiving cognitive behavioral therapy. Clinical Gerontologist, 38(2), 131–148.

    Article  Google Scholar 

  • Lin, C., Li, L., Ji, G., & Jie, W. (2015). Emotional social support and access to care among older people living with HIV in rural china. International Journal of Geriatric Psychiatry, 30(10), 1041–1047.

    Article  Google Scholar 

  • Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, 35, 80–94.

    Article  Google Scholar 

  • McLaughlin, E., Lefaivre, M. J., & Cummings, E. (2010). Experimentally-induced learned helplessness in adolescents with type 1 diabetes. Journal of Pediatric Psychology, 35(4), 405–414.

    Article  Google Scholar 

  • Moret, L., Nguyen, J. M., Pillet, N., Falissard, B., Lombrail, P., & Gasquet, I. (2007). Improvement of psychometric properties of a scale measuring inpatient satisfaction with care: A better response rate and a reduction of the ceiling effect. BMC Health Services Research, 7(197), 1–9.

    Google Scholar 

  • Nausheen, B., Gidron, Y., Gregg, A., Tissarchondou, H. S., & Peveler, R. (2007). Loneliness, social support and cardiovascular reactivity to laboratory stress. Stress, 10(1), 37–44.

    Article  Google Scholar 

  • Newall, N. E., Chipperfield, J. G., Bailis, D. S., & Stewart, T. L. (2013). Consequences of loneliness on physical activity and mortality in older adults and the power of positive emotions. Health Psychology, 32(8), 921–924.

    Article  Google Scholar 

  • Ong, A. D., Rothstein, J. D., & Uchino, B. N. (2012). Loneliness accentuates age differences in cardiovascular responses to social evaluative threat. Psychology and Aging, 27(1), 190–198.

    Article  Google Scholar 

  • Patterson, A. C., & Veenstra, G. (2010). Loneliness and risk of mortality: A longitudinal investigation in Alameda County, California. Social Science & Medicine, 71(1), 181–186.

    Article  Google Scholar 

  • Peck, B. M., Ubel, P. A., Roter, D. L., Goold, S. D., Asch, D. A., Mstat, A. S. J., et al. (2004). Do unmet expectations for specific tests, referrals, and new medications reduce patients’ satisfaction? Journal of General Internal Medicine, 19(11), 1080–1087.

    Article  Google Scholar 

  • Pierce, G. R., Sarason, B. R., Sarason, I. G., Joseph, H. J., & Henderson, C. A. (1996). Conceptualizing and assessing social support in the context of the family. In G. R. Pierce, B. R. Sarason, & I. G. Sarason (Eds.), Handbook of social support and the family (pp. 3–23). New York: Plenum Press.

    Chapter  Google Scholar 

  • Rhodes, A. E., & Bethell, J. (2008). Suicidal ideators without major depression: Whom are we not reaching? Canadian Journal of Psychiatry, 53(2), 125–130.

    Article  Google Scholar 

  • Rowe, J. L., Conwell, Y., Schulberg, H. C., & Bruce, M. L. (2006). Social support and suicidal ideation in older adults using home healthcare services. The American Journal of Geriatric Psychiatry, 14(9), 758–766.

    Article  Google Scholar 

  • Salonna, F., Geckova, A. M., Zezula, I., Sleskova, M., Groothoff, J. W., Reijneveld, S. A., et al. (2012). Does social support mediate or moderate socioeconomic differences in self-rated health among adolescents? International Journal of Public Health, 57(3), 609–617.

    Article  Google Scholar 

  • Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support: The social support questionnaire. Journal of Personality and Social Psychology, 44(1), 127–139.

    Article  Google Scholar 

  • Sarason, B. R., Shearin, E. N., Pierce, G. R., & Sarason, I. G. (1987). Interrelations of social support measures: Theoretical and practical implications. Journal of Personality and Social Psychology, 52(4), 813–832.

    Article  Google Scholar 

  • Shevlin, M., McElroy, E., & Murphy, J. (2015). Loneliness mediates the relationship between childhood trauma and adult psychopathology: Evidence from the adult psychiatric morbidity survey. Social Psychiatry and Psychiatric Epidemiology, 50(4), 591–601.

    Article  Google Scholar 

  • Sibley, L. M., & Glazier, R. H. (2009). Reasons for self-reported unmet healthcare needs in Canada: A population-based provincial comparison. Healthcare Policy, 5(1), 87–101.

    Google Scholar 

  • Siskind, D., Harris, M., Pirkis, J., & Whiteford, H. (2012). Personalised support delivered by support workers for people with severe and persistent mental illness: A systematic review of patient outcomes. Epidemiology and Psychiatric Sciences, 21(01), 97–110.

    Article  Google Scholar 

  • Sperry, D. M., & Widom, C. S. (2013). Child abuse and neglect, social support, and psychopathology in adulthood: A prospective investigation. Child Abuse and Neglect, 37(6), 415–425.

    Article  Google Scholar 

  • Statistics Canada. (2013). Canadian Community Health Survey-Mental Health: User guide microdata files. Statistics Canada. http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=5015. Accessed on April 12, 2014.

  • Statistics Canada. (2014). Canadian Community Health Survey (CCHS) Menta Health: Public use microdata file. Derived Variable (DV) Specifications. Statistics Canada http://odesi2.scholarsportal.info/documentation/CCHS_2012_MH/cchs_mh_derived_variables.pdf. Accessed on April 12, 2014.

  • Steele, L., Dewa, C., & Lee, K. (2007). Socioeconomic status and self-reported barriers to mental health service use. Canadian Journal of Psychiatry, 52(3), 201–206.

    Google Scholar 

  • Sunderland, A., & Findlay, L. C. (2013). Perceived need for mental health care in Canada: Results from the 2012 Canadian Community Health Survey-Mental Health. Health Reports/Statistics Canada, 24(9), 3–9.

    Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Pearson/Allyn & Bacon.

    Google Scholar 

  • Theeke, L., Horstman, P., Mallow, J., Lucke-Wold, N., Culp, S., & Domico, J., et al. (2014). Quality of life and loneliness in stroke survivors living in Appalachia. The Journal of Neuroscience Nursing, 46(6), E3–E15.

    Article  Google Scholar 

  • Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52(2), 145–161.

    Article  Google Scholar 

  • UCLA: Statistical Consulting Group. http://www.ats.ucla.edu/stat/spss/output/logistic.htm Accessed on November 9, 2015.

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  1. Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada

    Philip Baiden & Barbara Fallon

  2. School of Psychology, University of Ottawa, 136 Jean Jacques Lussier, Vanier Hall, Ottawa, ON, K1N 6N5, Canada

    Wendy den Dunnen

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  1. Philip Baiden
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Correspondence to Philip Baiden.

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Baiden, P., den Dunnen, W. & Fallon, B. Examining the Independent Effect of Social Support on Unmet Mental Healthcare Needs Among Canadians: Findings from a Population-Based Study. Soc Indic Res 130, 1229–1246 (2017). https://doi.org/10.1007/s11205-015-1224-y

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