Are mental health services underutilized?

Do you know someone who suffers from depression or do you yourself suffer from depression? Most people can answer yes to one of those two questions, and depression is only one of dozens of mental illnesses that plague the human population. Mental illnesses, such as depression, anxiety, multiple personalities disorder, or schizophrenia, are not just abstract concepts that make up the plot of popular horror movies. They are real issues that create real problems and are in need of real solutions. In the article, “Typology of  adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics” a study was conducted to develop a typology of individuals that suffered from mental illness in order to generate better and more efficient ways to improve the health care system to better serve the mentally ill. The study focused primarily on the predisposition, enabling factors, and needs factors of 2,433 people selected to participate in the study, as well as, the use of mental health services provided by those that had a history of mental illness.  

The study found that the most prevalent pre-disposing factors were gender, age, and marital status. Fifty six percent of participants were women around the mean age of 39.4 years. Fifty-one percent of the participants had never been married or were single. Socio-economic factors proved key in becoming enabling factors. Forty five percent of participants earned a salary as their primary source of income, and thirteen percent reported receiving government assistance in the form of welfare. Three percent received unemployment insurance, and the mean household income was $43,650. The needs related factors were shown to be major depressive episodes at fifty two percent, alcohol dependence at twenty-four percent, and social phobias at twenty percent. The average number of mental disorders per participant was found to be 1.47 disorders. These numbers reveal patterns of mental disorders  as an indirect result of various factors.

Among the 2,433 people that participated in the study, 406 people experienced at least one episode of mental disorder in the year prior to the study. Out of these 406 people, fifty-two percent, or 212 people, claimed to have used health care services for mental health issues at least one time. Most of the fifty-two percent suffered from major depressive episodes. The average number of services used by this section of the participants was 1.9 services. Most of the participants that had sought medical help used both primary care, which would include general practitioners, and specialized care, which would include psychiatrists and psychologists. Most of the participants that received specialized care had private health insurance. Forty of the participants consulted four or more different types of professionals. These numbers reveal patterns in the use of available public services for addressing mental disorders.

Through these findings the study found that there is an under use of the mental health services currently provided, with mostly woman taking advantage of them. The study found that because some services are underutilized and because mental illnesses vary with different pre-disposing factors, it is important to develop treatment programs for individual mental illnesses, and not more broad treatment programs that encompass the whole spectrum of mental illness. The study identified four main groups that need to be targeted, which include young females with anxiety disorders, middle aged, high income females with depressive disorders, young, low income earners with dependence disorders, and young low income earners with multiple mental and dependence disorders.  Outreach and promotion programs were found to be necessary for males specifically, as well as, for all four types of subgroups identified in the study.

Fleury, M., Grenier, G., Bamvita, J., Perreault, M., & Jean-Caron. (2011). Typology of adults diagnosed with mental disorders based on socio-demographics and clinical and service use characteristics. BMC Psychiatry, 11(1), 67-77. doi:10.1186/1471-244X-11-67