Perceived need for mental health care in Canada: Results from the 2012 Canadian Community Health Survey–Mental Health

There are a lot of Canadians whose mental health needs aren’t being met. Click here to learn more or read some excerpts below. Communities should be interested in the statistic 19.8% of individuals feel their needs for counselling are unmet. This is where communities can provide community programs to help these people heal.

 

Table 3
Percentage distribution of mental health care (MHC) need status, by type of MHC need, household population aged 15 or older with perceived MHC need, Canada excluding territories, 2012

Table 3
Percentage distribution of mental health care (MHC) need status, by type of MHC need, household population aged 15 or older with perceived MHC need, Canada excluding territories, 2012
Table summary
This table displays the results of percentage distribution of mental health care (mhc) need status. The information is grouped by type of mhc need (appearing as row headers), mhc need status, unmet, partially met, met and total, calculated using % units of measure (appearing as column headers).
Type of MHC need MHC need status
Unmet Partially met Met Total
%
Any 12.2 21.1 66.7 100.0
Information 24.5 6.3 69.2 100.0
Medication 4.2 4.9 90.9 100.0
Counselling 19.8 15.7 64.5 100.0
Other 0.0 17.3Note E: Use with caution 82.7 100.0
Date modified:
2015-07-17

 

In 2012, an estimated 17% of the population aged 15 or older reported having had an MHC need in the past 12 months. Two-thirds (67%) reported that their need was met; for another 21%, the need was partially met; and for 12%, the need was unmet. The most commonly reported need was for counselling, which was also the least likely to be met. Distress was identified as a predictor of perceived MHC need status.

Many Canadians are estimated to have MHC needs, particularly for counselling. People with elevated levels of distress are significantly more likely to have unmet and partially met MHC needs than to have fully met MHC needs, regardless of the presence of mental or substance disorders.

….

Many Canadians experience a need for mental health care (MHC), but not all of those needs are met. In fact, the presence of mental illness has repeatedly been associated with an MHC need, despite evidence-based practices suggesting that mental illness can be successfully treated. Rates of unmet needs were higher among people with the criteria for mental illness, especially those with depression. This is relevant considering that, in 2012, an estimated 10% of Canadians experienced a mental disorder (depression, bipolar disorder, generalized anxiety disorder, or alcohol, cannabis or substance abuse or dependence) in the past year. [Full Text]

 

Discussion

According to the results from the 2012 CCHS-MH, more than one in six Canadians aged 15 or older experienced a need for mental health care in the previous 12 months. An estimated 600,000 had a perceived  unmet MHC need, and more than 1,000,000 had a partially met need. The most common need was for counselling.

Similar to earlier studies that found greater MHC needs among people with concurrent mental or substance disorders,Note3,Note12 the present analysis shows that a large majority of those with a mood or anxiety disorder alone or with a concurrent substance disorder perceived an MHC need, compared with about one-quarter of those with only a substance disorder.

But as was reported in a 2002 study,Note12 experiencing a mental disorder was not necessarily associated with the degree to which needs were met.  Among individuals who perceived an MHC need, those with a mood or anxiety disorder, with or without a concurrent substance disorder, were more likely to have a partially met (rather than met) MHC need. They were not, however, more likely to have an unmet need, indicating that, along with perceiving a need, they were more likely to use MHC services. This finding illustrates the importance of disentangling the degree to which MHC needs are met.

Regardless of the presence of mental disorders, higher levels of distress were associated with the degree to which perceived MHCneeds were met, even when predisposing and enabling factors were accounted for. However, because the data are cross-sectional, directionality cannot be determined—people with distress may be more likely to perceive unmet needs, or people with unmet needs may be more likely to experience distress.

As in previous research,Note12 results suggest that individuals with chronic physical conditions were more likely to have a perceivedMHC need, compared with people who did not have such conditions. The current study also found that their MHC needs were less likely to be unmet (rather than met). This may reflect a tendency for people with multiple chronic conditions to have more frequent contact with medical professionals,Note34 and thereby be referred for MHC.

Although this analysis suggests a link between physical and mental health, previous research helps highlight the differences in barriers to MHC and barriers to health care in general. In the current study, 19% of perceived unmet or partially met needs were attributed to features of the health care system measured in the 2012 CCHS-MH, and 73% to personal circumstance. By comparison, Sanmartin et al.Note31 found 52% of individuals reported that barriers to health care in general were a result of features of the health care system, and 69% attributed barriers to personal circumstances. Additionally, in the current study, nearly half of respondents with an unmet or partially met MHC need reported that they preferred to manage the need on their own.

Limitations and future directions
Several limitations of this analysis must be acknowledged. Mental disorders were identified by an algorithm based on responses to the CIDI, not a clinical diagnosis. Also, only certain mental disorders were included on the 2012 CCHS-MH (for instance, personality disorders were not considered). Additionally, the sample did not include the institutionalized population. Taken together, the prevalence of mental disorders and MHC needs may be underestimated.

Moreover, the focus was on perceptions of MHC needs, which excludes people who do not perceive a need, but who might benefit from MHC services. Future research based on the CCHS-MH might consider differences in perceived need status by service use.

Finally, this study does not account for some factors that may influence MHC needs—for example, whether individuals have a regular physician or insurance coverage.Note24

Conclusion

The strengths of this analysis include an examination of MHC needs by type (information, medication, counselling, and other), a determination of the degree to which MHC needs are met (fully, partially, or unmet), and a large, population-based sample. The results suggest that many Canadians perceive an MHC need, particularly for counselling. The presence of a mental disorder, higher distress, and chronic physical conditions were positively associated with perceiving an MHC need, many of which were unmet or only partially met. As well, higher levels of distress predicted a greater likelihood that needs would be unmet or partially met. Most perceived barriers to receiving MHC were related to personal circumstances, although almost one in five who reported barriers said they were related to features of the health care system.

Acknowledgements

The authors appreciatively acknowledge the input of Philippe Finès on the analytical approach, and Claudia Sanmartin for comments on an earlier draft of the manuscript.

Date modified:
2015-07-17

 

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