Abstract
Anxiety disorders are a significant mental health problem. Despite the availability of effective treatments most sufferers do not seek help. The current study assesses delays in treatment-seeking, failure to seek treatment, and reasons for delaying treatment for individuals with anxiety disorders. Data were drawn from the Collaborative Psychiatric Epidemiological Surveys including 3,805 participants and analyses focused on treatment-seeking variables. Results indicate that individuals with anxiety disorders are less likely to seek treatment from a professional and more likely to experience delays in obtaining both any treatment, and effective treatment, than individuals with other forms of mental illness (in this case unipolar depression or substance use disorders). Deficits in mental health literacy (knowledge and beliefs about mental illness) were commonly endorsed as reasons for having delayed seeking treatment. The current study highlights the importance of improving knowledge about anxiety disorders to improve treatment-seeking.
Notes
Obsessive compulsive disorder was not reliably identified in the WMH-CIDI so data are not available. Separation anxiety disorder was not included as it is a childhood diagnosis and this sample consisted of only adults.
Nicotine dependence was not included.
Hypomanic episodes were excluded from this category.
References
Alegria, M., Takeuchi, D., Canino, G., Duan, N., Shrout, P., Meng, X. L., et al. (2004). Considering context, place and culture: The National Latino and Asian American Study. International Journal of Methods in Psychiatric Research, 13, 208–220.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th edn. Text Revision ed.). Arlington, VA.
Andrews, G. (2006). It would be cost-effective to treat more people with mental disorders. Australian and New Zealand Journal of Psychiatry, 40, 613–615.
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230.
Barney, L. J., Griffiths, K. M., Jorm, A. F., & Christensen, H. (2006). Stigma about depression and its impact on help-seeking intentions. Australian and New Zealand Journal of Psychiatry, 40, 51–54.
Coles, M. E., Turk, C. L., Jindra, L., & Heimberg, R. G. (2004). The path from initial inquiry to initiation of treatment for social anxiety disorder in an anxiety disorders specialty clinic. Journal of Anxiety Disorders, 18, 371–383.
Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625.
DuPont, R. L., Rice, D. P., Miller, L. S., Shiraki, S. S., Rowland, C. R., & Harwood, H. J. (1996). Economic costs of anxiety disorders. Anxiety, 2, 167–172.
Greenberg, P. E., Sisitsky, T., Kessler, R. C., Finkelstein, S. N., Berndt, E. R., Davidson, J. R. T., et al. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427–435.
Hoffman, D. L., Dukes, E. M., & Wittchen, H. (2008). Human and economic burden of generalized anxiety disorder. Depression and Anxiety, 25, 72–90.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 169–183.
Hollander, E. (1997). Obsessive-compulsive disorder: The hidden epidemic. Journal of Clinical Psychiatry, 58, 3–6.
Jackson, J. S., Torres, M., Caldwell, C. H., Neighbors, H. W., Nesse, R. M., Taylor, R. J., et al. (2004). The National Survey of American life: A study of racial, ethnic and cultural influences on mental disorders and mental health. International Journal of Methods in Psychiatric Research, 13, 196–207.
Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). ``Mental health literacy’’: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. The Medical Journal of Australia, 166, 182–186.
Kessler, R. C., Berglund, P., Chiu, W. T., Demler, O., Heeringa, S., Hiripi, E., et al. (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research, 13, 69–92.
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–602.
Keyes, K. M., Hatzenbuehler, M. L., Alberti, P., Narrow, W. E., Grant, B. F., & Hasin, D. S. (2008). Service utilization differences for axis I psychiatric and substance use disorders between white and black adults. Psychiatric Services, 59, 893–901.
Lefebvre, J., Lesage, A., Cyr, M., Toupin, J., & Fournier, L. (1998). Factors related to utilization of services for mental health reasons in Montreal, Canada. Social Psychiatry and Psychiatric Epidemiology, 33, 291–298.
Lim, D., Sanderson, K., & Andrews, G. (2000). Lost productivity among full-time workers with mental disorders. Journal of Mental Health Policy and Economics, 3, 139–146.
Lin, E., & Parikh, S. V. (1999). Sociodemographic, clinical, and attitudinal characteristics of the untreated depressed in Ontario. Journal of Affective Disorders, 53, 153–162.
McHugh, R. K., Smits, J. A. J., & Otto, M. W. (2009). Empirically supported treatments for panic disorder. Psychiatric Clinics of North America, 32, 593–610.
Mojtabai, R., Olfson, M., & Mechanic, D. (2002). Perceived need and help-seeking in adults with mood, anxiety, or substance use disorder. Archives of General Psychiatry, 59, 77–84.
Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy Theory, Research, Practice, and Training, 45, 214–226.
Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in the anxiety disorders: A meta-analytic review. Clinical Psychology Review, 27, 572–581.
Paykel, E. S., Hart, D., & Priest, R. G. (1998). Changes in public attitudes to depression during the Defeat Depression Campaign. British Journal of Psychiatry, 173, 519–522.
Prins, M. A., Verhaak, P. F. M., Bensing, J. M., & van der Meer, K. (2008). Health beliefs and perceived need for mental health care of anxiety and depression—the patients’ perspective explored. Clinical Psychology Review, 28, 1038–1058.
Roness, A., Mykletun, A., & Dahl, A. A. (2005). Help-seeking behavior in patients with anxiety disorder and depression. Acta Psychiatrica Scandinavica, 111, 51–58.
Stein, D. J., Denys, D., Gloster, A. T., Hollander, E., Leckman, J. F., Rauch, S. L., et al. (2009). Obsessive–compulsive disorder: Diagnostic and treatment issues. Psychiatric Clinics of North America, 32, 665–685.
Stewart, R. E., & Chambless, D. L. (2009). Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 77, 595–606.
Thompson, A., Hunt, C., & Issakidis, C. (2004). Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample. Social Psychiatry and Psychiatric Epidemiology, 39, 810–817.
Vanheusden, K., Mulder, C. L., van der Ende, J., van Lenthe, F. J., Mackenbach, J. P., & Verhulst, F. C. (2008). Young adults face major barriers to seeking help from mental health services. Patient Education and Counseling, 73, 97–104.
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 603–613.
Wells, J. E., Robins, L. N., Bushnell, J. A., & Jarosz, D. (1994). Perceived barriers to care in St. Louis (USA) and Christchurch (NZ): Reasons for not seeking professional help for psychological distress. Social Psychiatry and Psychiatric Epidemiology, 29, 155–164.
Wittchen, H. (2002). Generalized anxiety disorder: Prevalence, burden, and cost to society. Depression and Anxiety, 16, 162–171.
Worden, J. K., Flynn, B. S., Solomon, L. J., Secker-Walker, R. H., Badger, G. J., & Carpenter, J. H. (1996). Using mass media to prevent cigarette smoking among adolescent girls. Health Education and Behavior, 23, 453–468.
Wright, A., McGorry, P. D., Harris, M. G., Jorm, A. F., & Pennell, K. (2006). Development and evaluation of a youth mental health community awareness campaign—The compass strategy. BMC Public Health, 6, 215.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Johnson, E.M., Coles, M.E. Failure and Delay in Treatment-Seeking Across Anxiety Disorders. Community Ment Health J 49, 668–674 (2013). https://doi.org/10.1007/s10597-012-9543-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-012-9543-9