Abstract
BackgroundThis study ascertain gender-specific determinants of outpatient mental health (MH) service use for depression to highlight gender disparities in barriers to care and explain how depressed men and women in need of care might differ in their help-seeking behaviour.MethodsData used in this study came from the Canadian Community Health Survey on Mental Health and Well Being, cycle 1.2 (CCHS 1.2) conducted by Statistics Canada in 2002 (N = 36,984). The sample was limited to respondents filling the criteria for a probable major depression in the 12 months prior to the interview (n = 1743). Gender-specific multivariate logistic regression analyses were carried out.ResultsThe results showed that 54.3% of respondents meeting criteria for major depression had consulted for mental health reasons in the year prior to interview. When looking at type of outpatient mental health service use, males were more likely to consult a general practitioner and a mental health specialist in the past year as opposed to females. However, females were more likely to consult a general practitioner only as opposed to no service use than males. Gender specific differences in determinants associated with outpatient service use included for males, lower adjusted household income, and for females, a younger age, the presence of social support, self-reported availability barriers, the presence of self-reported suicidal thoughts or attempt and a poorer self- perceived mental health.ConclusionsIt is concluded that continued efforts to promote access to mental health care are needed for men and women affected by depression, and this, to target specific vulnerable populations and increase utilization rates.
Highlights
This study ascertained gender-specific determinants of outpatient mental health (MH) service use for depression to highlight any gender disparities in barriers to care and explain how depressed men and women in need of care might differ in their help-seeking behaviour
The multinomial regression analyses showed that the odds of consulting a general practitioners (GP)/family physicians (FP) and a mental health specialist in the past year as opposed to a GP/FP only was 1.4 times larger in males than females (1.41 OR; 95% CI: 1.02 – 1.94)
Gender specific differences in determinants associated with outpatient service use included for males, lower adjusted household income (2.14 OR; 95% CI: 1.24–3.71), and for females, younger age [(25 to years (2.77 OR; 95% CI: 1.34–5.74); to 64 years (2.59 OR; 95% CI: 1.24–5.42)], the presence of social support (2.63 OR; 95% CI: (1.43 – 4.76), selfreported availability barriers (2.05 OR; 95% CI: 1.02–4.10), the presence of self-reported suicidal thoughts or attempt (2.80 OR; 95% CI: 1.92–4.09) and a poorer self-perceived mental health (1.80 OR; 95% CI: 1.27–2.55)
Summary
This study ascertained gender-specific determinants of outpatient mental health (MH) service use for depression to highlight any gender disparities in barriers to care and explain how depressed men and women in need of care might differ in their help-seeking behaviour. An earlier study, focusing on gender differences by type of mental health service use, showed that females were more likely to consult general medical services, but not specialised mental health services [31]. Using data from a Canadian population based community sample of adults aged 18–65 years old, Drapeau and colleagues (2009) showed that women were more likely to use general medical services, psychological services and psychiatric services and this after controlling for the presence of major depression [44]. Other studies have shown greater use of mental health specialised services in men [22,35]
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