Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-23T08:35:01.865Z Has data issue: false hasContentIssue false

Gender-related patterns and determinants of recent help-seeking for past-year affective, anxiety and substance use disorders: findings from a national epidemiological survey

Published online by Cambridge University Press:  02 October 2015

M. G. Harris*
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland 4076, Australia
A. J. Baxter
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland 4076, Australia
N. Reavley
Affiliation:
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
S. Diminic
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland 4076, Australia
J. Pirkis
Affiliation:
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3010, Australia
H. A. Whiteford
Affiliation:
School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland 4076, Australia
*
*Address for correspondence: M. Harris, Queensland Centre for Mental Health Research, The Park – Centre for Mental Health, Locked Bag 500, Sumner Park BC QLD 4074, Australia. (Email: meredith_harris@qcmhr.uq.edu.au)

Abstract

Aims.

To examine: (1) gender-specific determinants of help-seeking for mental health, including health professional consultation and the use of non-clinical support services and self-management strategies (SS/SM) and; (2) gender differences among individuals with unmet perceived need for care.

Method.

Analyses focused on 689 males and 1075 females aged 16–85 years who met ICD-10 criteria for a past-year affective, anxiety or substance use disorder in an Australian community-representative survey. Two classifications of help-seeking for mental health in the previous year were created: (1) no health professional consultation or SS/SM, or health professional consultation, or SS/SM only, and; (2) no general practitioner (GP) or mental health professional consultation, or GP only consultation, or mental health professional consultation. Between- and within-gender help-seeking patterns were explored using multinomial logistic regression models. Characteristics of males and females with unmet perceived need for care were compared using chi-square tests.

Results.

Males with mental or substance use disorders had relatively lower odds than females of any health professional consultation (adjusted odds ratio [AOR] = 0.46), use of SS/SM only (AOR = 0.59), and GP only consultation (AOR = 0.29). Notably, males with severe disorders had substantially lower odds than females of any health professional consultation (AOR = 0.29) and GP only consultation (AOR = 0.14). Most correlates of help-seeking were need-related. Many applied to both genders (e.g., severity, disability, psychiatric comorbidity), although some were male-specific (e.g., past-year reaction to a traumatic event) or female-specific (e.g., past-year affective disorder). Certain enabling and predisposing factors increased the probability of health professional consultation for both genders (age 30+ years) or for males (unmarried, single parenthood, reliance on government pension). Males with unmet perceived need for care were more likely to have experienced a substance use disorder and to want medicine or tablets or social intervention, whereas their females peers were more likely to have experienced an anxiety disorder and to want counselling or talking therapy. For both genders, attitudinal/knowledge barriers to receiving the types of help wanted (e.g., not knowing where to get help) were more commonly reported than structural barriers (e.g., cost).

Conclusions.

Findings suggest a need to address barriers to help-seeking in males with severe disorders, and promote GP consultation. Exploring gender-specific attitudinal/knowledge barriers to receiving help, and the types of help wanted, may assist in designing interventions to increase consultation. Mental health promotion/education efforts could incorporate information about the content and benefits of evidence-based treatments and encourage males to participate in other potentially beneficial actions (e.g., physical activity).

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

ABS (2008 a). 2007 National Survey of Mental Health and Wellbeing: Summary of Results (Cat. No. 4326.0). Australian Bureau of Statistics: Canberra.Google Scholar
ABS (2008 b). Information Paper: an Introduction to Socio-Economic Indexes for Areas (SEIFA), 2006 (Cat. No. 2039.0). Australian Bureau of Statistics: Canberra.Google Scholar
ABS (2013). 3303.0 – Causes of Death, Australia, 2011. Australian Bureau of Statistics: Canberra.Google Scholar
Albizu-Garcia, C, Alegria, M, Freeman, D, Vera, M (2001). Gender and health services use for a mental health problem. Social Science and Medicine 53, 865878.Google Scholar
Andersen, R, Newman, J (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly 51, 95124.Google Scholar
Andrade, LH, Alonso, J, Mneimneh, Z, Wells, JE, Al-Hamzawi, A, Borges, G, Bromet, E, Bruffaerts, R, de Girolamo, G, de Graaf, R, Florescu, S, Gureje, O, Hinkov, HR, Hu, C, Huang, Y, Hwang, I, Jin, R, Karam, EG, Kovess-Masfety, V, Levinson, D, Matschinger, H, O'Neill, S, Posada-Villa, J, Sagar, R, Sampson, NA, Sasu, C, Stein, DJ, Takeshima, T, Viana, MC, Xavier, M, Kessler, RC (2014). Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological Medicine 44, 13031317.Google Scholar
Bayram, C, Fahridin, S, Britt, H (2009). Men and mental health. Australian Family Physician 38, 91.Google ScholarPubMed
Bijl, R, Ravelli, A (2000). Psychiatric morbidity, service use, and need for care in the general population: results of the Netherlands Mental Health Survey and Incidence Study. American Journal of Public Health 90, 602607.Google ScholarPubMed
Brownhill, S, Wilhelm, K, Eliovson, G, Waterhouse, M (2003). ‘For men only’. A mental health prompt list in primary care. Australian Family Physician 32, 443450.Google Scholar
Burgess, PM, Pirkis, JE, Slade, TN, Johnston, AK, Meadows, GN, Gunn, JM (2009). Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry 43, 615623.CrossRefGoogle ScholarPubMed
Burns, B, Wagner, R, Gaynes, B, Wells, K, Schulberg, H (2000). General medical and specialty mental health service use for major depression. International Journal of Psychiatry in Medicine 30, 127143.Google Scholar
Burns, J, Webb, M, Durkin, L, Hickie, I (2010). Reach out central: a serious game designed to engage young men to improve mental health and wellbeing. Medical Journal of Australia 192, S27S30.Google Scholar
Codony, M, Alonso, J, Almansa, J, Bernert, S, de Girolamo, G, De Graaf, R, Haro, JM, Kovess, V, Vilagut, G, Kessler, R (2009). Perceived need for mental health care and service use among adults in western Europe: results of the ESEMeD Project. Psychiatric Services 60, 10511058.Google Scholar
Cox, D (2014). Gender differences in professional consultation for a mental health concern: a Canadian population study. Canadian Psychology 55, 6874.CrossRefGoogle Scholar
Department of Health (2010). National Male Health Policy Supporting Document: Healthy Minds. Australian Government Department of Health: Canberra.Google Scholar
Department of Health and Ageing (2009). Fourth National Mental Health Plan – an Agenda for Collaborative Government Action in Mental Health 2009–2014. Department of Health and Ageing: Canberra.Google Scholar
Elhai, JD, Patrick, SL, Anderson, S, Simons, JS, Frueh, BC (2006). Gender- and trauma-related predictors of use of mental health treatment services among primary care patients. Psychiatric Services 57, 15051509.CrossRefGoogle ScholarPubMed
Fleury, M-J, Grenier, G, Bamvita, J-M, Caron, J (2014). Determinants and patterns of service utilization and recourse to professionals for mental health reasons. BMC Health Services Research 14, 161.Google Scholar
Gagne, S, Vasiliadis, HM, Preville, M (2014). Gender differences in general and specialty outpatient mental health service use for depression. BMC Psychiatry 14, 135.CrossRefGoogle ScholarPubMed
Galdas, P, Cheater, F, Marshall, P (2005). Men and help-seeking behaviour: literature review. Journal of Advanced Nursing 49, 616623.CrossRefGoogle ScholarPubMed
Grella, C, Greenwell, L, Mays, V, Cochran, S (2009). 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 9, 52.Google Scholar
Hauenstein, EJ, Petterson, S, Merwin, E, Rovnyak, V, Heise, B, Wagner, D (2006). Rurality, gender, and mental health treatment. Family and Community Health 29, 169185.CrossRefGoogle ScholarPubMed
Holzinger, A, Floris, F, Schomerus, G, Carta, MG, Angermeyer, MC (2012 a). Gender differences in public beliefs and attitudes about mental disorder in western countries: a systematic review of population studies. Epidemiology and Psychiatric Sciences 21, 7385.CrossRefGoogle ScholarPubMed
Holzinger, A, Matschinger, H, Angermeyer, MC (2012 b). What to do about depression? Self-help recommendations of the public. International Journal of Social Psychiatry 58, 343349.CrossRefGoogle Scholar
Jorm, AF, Medway, J, Christensen, H, Korten, AE, Jacomb, PA, Rodgers, B (2000). Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Australian and New Zealand Journal of Psychiatry 34, 619626.Google Scholar
Kessler, R, Üstün, T (2004). The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.CrossRefGoogle ScholarPubMed
Kilmartin, C (2005). Depression in men: communication, diagnosis and therapy. Journal of Men's Health & Gender 2, 9599.CrossRefGoogle Scholar
Kovess-Masfety, V, Boyd, A, van de Velde, S, de Graaf, R, Vilagut, G, Haro, JM, Florescu, S, O'Neill, S, Weinberg, L, Alonso, J (2014). Are there gender differences in service use for mental disorders across countries in the European Union? Results from the EU-World Mental Health survey. Journal of Epidemiology and Community Health 68, 649656.Google Scholar
Leaf, P, Bruce, M (1987). Gender differences in the se of mental health-related services: a re-examination. Journal of Health and Social Behavior 28, 171183.CrossRefGoogle Scholar
Levinson, D, Ifrah, A (2010). The robustness of the gender effect on help seeking for mental health needs in three subcultures in Israel. Social Psychiatry and Psychiatric Epidemiology 45, 337344.Google Scholar
Mann, J, Apter, AJ, Bertolote, J, Beautrais, A, Currier, D, Haas, A, Hegerl, U, Lonnqvist, J, Malone, K, Marusic, A, Mehlum, L, Patton, G, Phillips, M, Rutz, M, Rihmer, Z, Schmidtke, A, Shaffer, D, Silverman, M, Takahashi, Y, Varnik, A, Wasserman, D, Yip, P, Hendin, H (2005). Suicide prevention strategies: a systematic review. Journal of the American Medical Association 294, 20642074.CrossRefGoogle ScholarPubMed
Matheson, F, Smith, K, Fazli, G, Moineddin, R, Dunn, J, Glazier, R (2014). Physical health and gender as risk factors for usage of services for mental illness. Journal of Epidemiology and Community Health 68, 971978.Google Scholar
McGorry, P, Tanti, C, Stokes, R, Hickie, I, Carnell, K, Littlefield, L, Moran, J (2007). headspace: Australia's National Youth Mental Health Foundation – where young minds come first. Medical Journal of Australia 187, S68S70.CrossRefGoogle ScholarPubMed
Meadows, G, Harvey, C, Fossey, E, Burgess, P (2000). Assessing perceived need for mental health care in a community survey: development of the Perceived Need for Care Questionnaire (PNCQ). Social Psychiatry and Psychiatric Epidemiology 35, 427435.Google Scholar
Mental Health and Drugs Division (2009). Because Mental Health Matters: Victorian Mental Health Reform Strategy 2009–2019. Department of Human Services, Victorian Government: Melbourne.Google Scholar
Mojtabai, R, Olfson, M, Sampson, NA, Jin, R, Druss, B, Wang, PS, Wells, KB, Pincus, HA, Kessler, RC (2011). Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychological Medicine 41, 17511761.Google Scholar
Moller-Leimkuhler, AM (2002). Barriers to help-seeking by men: a review of sociocultural and clinical literature with particular reference to depression. Journal of Affective Disorders 71, 19.Google Scholar
New Zealand Minister of Health (2006). Te Tāhuhu – Improving Mental Health 2005–2015: The Second New Zealand Mental Health and Addiction Plan. Ministry of Health: Wellington.Google Scholar
Nowshad, G (2011). Gender Disparities in Utilization, Unmet Need and Expenditure for Mental Health Care. The University of Texas: Houston, TX.Google Scholar
Ojeda, VD, Bergstresser, SM (2008). Gender, race-ethnicity, and psychosocial barriers to mental health care: an examination of perceptions and attitudes among adults reporting unmet need. Journal of Health and Social Behavior 49, 317334.CrossRefGoogle ScholarPubMed
Olesen, SC, Butterworth, P, Leach, L (2010). Prevalence of self-management versus formal service use for common mental disorders in Australia: findings from the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry 44, 823830.Google Scholar
Parslow, RA, Lewis, V, Marsh, G (2011). The general practitioner's role in providing mental health services to Australians, 1997 and 2007: findings from the national surveys of mental health and wellbeing. Medical Journal of Australia 195, 205209.CrossRefGoogle ScholarPubMed
Prins, M, Meadows, G, Bobevski, I, Graham, A, Verhaak, P, van der Meer, K, Penninx, B, Bensing, J (2011). Perceived need for mental health care and barriers to care in the Netherlands and Australia. Social Psychiatry and Psychiatric Epidemiology 46, 10331044.Google Scholar
Proudfoot, H, Teesson, M (2001). Who Seeks Treatment for Alcohol Dependence? Findings from the Australian National Survey of Mental Health and Wellbeing. Technical Report Number 122. NDARC: Sydney.Google Scholar
Reavley, N, Cvetkovski, S, Jorm, A (2011). Sources of information about mental health and links to help seeking: findings from the 2007 National Survey of Mental Health and Wellbeing. Social Psychiatry and Psychiatric Epidemiology 46, 12671274.CrossRefGoogle ScholarPubMed
Reavley, NJ, Jorm, AF (2011 a). Recognition of mental disorders and beliefs about treatment and outcome: findings from an Australian National Survey of Mental Health Literacy and Stigma. Australian and New Zealand Journal of Psychiatry 45, 947956.Google Scholar
Reavley, NJ, Jorm, AF (2011 b). Stigmatizing attitudes towards people with mental disorders: findings from an Australian National Survey of Mental Health Literacy and Stigma. Australian and New Zealand Journal of Psychiatry 45, 10861093.Google Scholar
Reavley, NJ, Cvetkovski, S, Jorm, AF, Lubman, DI (2010). Help seeking for substance use, anxiety and affective disorders among young people: results from the 2007 Australian National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry 44, 729735.Google Scholar
Rhodes, A, Jaakkimainen, RL, Bondy, S, Fung, K (2006). Depression and mental health visits to physicians – a prospective records-based study. Social Science and Medicine 62, 828834.Google Scholar
Rhodes, AE, Goering, PN, To, T, Williams, JI (2002). Gender and outpatient mental health service use. Social Science and Medicine 54, 110.Google Scholar
Rickwood, DJ, Deane, FP, Wilson, CJ (2007). When and how do young people seek professional help for mental health problems? Medical Journal of Australia 187(7 Suppl.), S35S39.Google Scholar
Rochlen, AB, Paterniti, DA, Epstein, RM, Duberstein, P, Willeford, L, Kravitz, RL (2010). Barriers in diagnosing and treating men with depression: a focus group report. American Journal of Men's Health 4, 167175.Google Scholar
Rosenbaum, S, Tiedemann, A, Sherrington, C, Curtis, J, Ward, P (2014). Physical activity interventions for people with mental illness: a systematic review and meta-analysis. Journal of Clinical Psychiatry 75, 964974.CrossRefGoogle ScholarPubMed
Sareen, J, Jagdeo, A, Cox, BJ, Clara, I, ten Have, M, Belik, S-L, de Graaf, R, Stein, MB (2007). Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatric Services 58, 357364.Google Scholar
Schmitz, R, Jordan, S, Muters, S, Neuhauser, H (2012). Population-wide use of behavioural prevention and counselling programmes for lifestyle-related cardiovascular risk factors in Germany. European Journal of Preventative Cardiology 19, 849856.Google Scholar
Slade, T, Johnston, A, Oakley Browne, MA, Andrews, G, Whiteford, H (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australian and New Zealand Journal of Psychiatry 43, 594605.Google Scholar
Smith, K, Matheson, F, Moineddin, R, Dunn, J, Lu, H, Cairney, J, Glazier, R (2013). Gender differences in mental health service utilization among respondents reporting depression in a national health survey. Health 5, 15611571.Google Scholar
South Australia Health (2010). South Australia's Mental Health and Wellbeing Policy 2010–2015. Government of South Australia: Adelaide.Google Scholar
Starkes, JM, Poulin, CC, Kisely, SR (2005). Unmet need for the treatment of depression in Atlantic Canada. Canadian Journal of Psychiatry 50, 580590.Google Scholar
StataCorp. (2009). Stata Statistical Software: Release 11. StataCorp LP: College Station, TX.Google Scholar
Tedstone Doherty, D, Kartalova-O'Doherty, Y (2010). Gender and self-reported mental health problems: predictors of help seeking from a general practitioner. British Journal of Health Psychology 15, 213228.Google Scholar
Teesson, M, Slade, T, Mills, K (2009). Comorbidity in Australia: findings of the 2007 National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry 43, 606614.Google Scholar
Trojan, A, Nickel, S, Amhof, R, Böcken, J (2006). Social factors influencing participation in self-help groups or organizations: results from selected questions for the Health Monitor. Gesundheitswesen 68, 364375.Google Scholar
UK Department of Health (2011). No Health Without Mental Health: a Cross-Government Mental Health Outcomes Strategy for People of All Ages. Department of Health: London.Google Scholar
Wang, D, Wang, Y, Wang, Y, Li, R, Zhou, C (2014). Impact of physical exercise on substance use disorders: a meta-analysis. PLoS ONE.Google Scholar
Wang, J, Patten, S (2007). Perceived effectiveness of mental health care provided by primary care physicians and mental health specialists. Psychosomatics 48, 123127.CrossRefGoogle ScholarPubMed
Wang, PS, Lane, M, Olfson, M, Pincus, HA, Wells, KB, Kessler, RC (2005). Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 629640.Google Scholar
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bromet, EJ, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gureje, O, Haro, JM, Karam, EG, Kessler, RC, Kovess, V, Lane, MC, Lee, S, Levinson, D, Ono, Y, Petukhova, M, Posada-Villa, J, Seedat, S, Wells, JE (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 370, 841850.Google Scholar
Wegner, M, Helmich, I, Machado, S, Nardi, A, Arias-Carrion, O, Budde, H (2014). Effects of exercise on anxiety and depression disorders: review of meta-analyses and neurobiological mechanisms. CNS & Neurological Disorders-Drug Targets 13, 10021014.CrossRefGoogle ScholarPubMed
World Health Organization (1992). International Statistical Classification of Diseases and Related Health Problems, 10th revision. World Health Organization: Geneva.Google Scholar
Supplementary material: File

Harris supplementary material

Table S1-S2

Download Harris supplementary material(File)
File 34.5 KB