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Trends in non-help-seeking for mental disorders in Germany between 1997–1999 and 2009–2012: a repeated cross-sectional study

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Abstract

Purpose

This study sought to examine trends in non-help-seeking for mental disorders among persons with a prevalent mental disorder (12-month prevalence) in Germany between 1997–1999 and 2009–2012.

Methods

We examined data from 1909 persons aged 18–65 years who participated in two independent, repeated cross-sectional surveys (German National Interview and Examination Study 1997–1999, German Health Interview and Examination Survey for Adults 2009–2012) conducted 12 years apart. Prevalent mental disorders (12-month prevalence) were determined using the Composite International Diagnostic Interview, which included information on lifetime help-seeking for mental health problems. Correlates of self-reported help-seeking were analyzed according to Andersen’s Behavioral Model. Multivariable Poisson regression models were used to assess time trends in the directly standardized and model-adjusted prevalence of non-help-seeking across strata of socio-economic and clinical variables.

Results

The proportion of people with a prevalent mental disorder who have never sought help in their lifetime decreased significantly from 62% (95% CI 58.7–64.7) to 57% (95% CI 52.2–60.9) between 1997–1999 and 2009–2012 in adults aged 18–65 years in Germany. Downward trends in non-help-seeking occurred in all investigated strata and reached statistical significance in women, in people who were living alone, people with medium educational level, people living in middle-sized communities, people with non-statutory health insurance, smokers, and people with co-existing somatic conditions.

Conclusion

Despite a downward trend over the course of 12 years, a large proportion of people suffering from mental disorders are still not seeking treatment in Germany. Further efforts to increase uptake of help-seeking for mental disorders in hard-to-reach groups are warranted to continue this trend.

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Acknowledgements

This study was conducted in collaboration with the Robert Koch Institute, Berlin as a part of projects evaluating the DEGS1-MH survey. It was funded by the German Federal Ministry of Health (Chapter 1501, title 544 01; 1368-1124). GHS-MHS was supported by Grant 01EH970/8 (German Federal Ministry of Research, Education and Science; BMBF). DEGS1 and DEGS1-MH are projects by the Robert Koch Institute (Berlin, Germany) funded primarily by the German Ministry of Health (BMG). Supplementary funding was provided by the Technische Universität Dresden, and by the Stiftung Seelische Gesundheit inaugurated by the German Association for Psychiatry and Psychotherapy (DGPPN). The contributions to data collection made by field workers, technicians, interviewers, and computer assistants are gratefully acknowledged. Above all, the authors wish to thank all the GHS-MHS and DEGS1-MH study participants.

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Authors and Affiliations

  1. Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany

    Susanne Brandstetter, Frank Dodoo-Schittko & Christian Apfelbacher

  2. Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany

    Sven Speerforck, Hans-Jörgen Grabe & Georg Schomerus

  3. Psychologische Hochschule Berlin, Berlin, Germany

    Frank Jacobi

  4. Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany

    Ulfert Hapke

  5. Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany

    Sebastian E. Baumeister

  6. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

    Sebastian E. Baumeister

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  1. Susanne Brandstetter
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  2. Frank Dodoo-Schittko
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  3. Sven Speerforck
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  4. Christian Apfelbacher
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  5. Hans-Jörgen Grabe
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  6. Frank Jacobi
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  7. Ulfert Hapke
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  8. Georg Schomerus
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  9. Sebastian E. Baumeister
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Corresponding author

Correspondence to Susanne Brandstetter.

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Ethical statement

All participants gave informed consent prior to their inclusion in the studies. GHS-MHS: The study was approved by the responsible Institutional Review Board and Ethics Committee. DEGS1 and DEGS1-MH: the study was approved by the Medical Ethics Review Committees responsible for DEGS1 (Charité, Berlin) and for DEGS1-MH by the Ethics Board of the Technische Universität Dresden, respectively.

Conflict of interest

The authors declare that they have no conflict of interest.

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Brandstetter, S., Dodoo-Schittko, F., Speerforck, S. et al. Trends in non-help-seeking for mental disorders in Germany between 1997–1999 and 2009–2012: a repeated cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 52, 1005–1013 (2017). https://doi.org/10.1007/s00127-017-1384-y

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  • DOI: https://doi.org/10.1007/s00127-017-1384-y

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