Friday, 13 February 2009

Why do some people get help for mental health problems and some don’t

It has always intrigued me why some people get help for mental health problems and some don’t. What seems clear is that it is only partly related to need or severity of problems. A recent paper (Receiving treatment for common mental disorders
Verhaak, P. F., et al Gen Hosp Psychiatry 2009; 31: 46-55) sheds some light on this issue by looking at 743 people from a sample of GP attendees (attending for any reason) with anxiety or depression in the Netherlands. Only just over half of them had received any treatment in the last six months from their GP and about one in seven had received treatment from mental health services. You were more likely to get treatment from your GP if you were younger (just odds ratio 0.96); thought they communicated well (odds ratio 1.64); and recognised you had a mental health problem (odds ratio 7.43)(not surprisingly). Treatment in secondary care was associated with confidence in professional help (odds ratio 1.73) and number of diagnoses (odds ratio 1.47) with no relationship to the severity of anxiety or depressive symptoms.

This emphasises that accessing GP help is dependent on people being mental health literate and recognising that what they are experiencing could be due to a mental disorder. This study only looked at characteristics of the patients and not that of the services they were trying to access. As treatment involves at least two parties this seems to me an important omission which no doubt will be addressed in future studies.