Self-help behaviour of Canadians with perceived needs for mental health care.

Abstract

Although there are a wide variety of efficacious therapies available to individuals with mental health care needs, many individuals are not receiving adequate treatment (Bijl et al., 2003; Demyttenaere et al., 2004; Kessler et al., 2005; Wang, Berglund, & Kessler, 2000). This is a considerable problem given that in 2012 about 9.1 million Canadians met criteria for at least one of six selected mental disorders1 during their lifetime (Pearson, Janz, & Ali, 2013). It may be the case that these individuals are not seeking the help that they require; however, a lack of treatment may be because of barriers in mental health service utilization. Self-help treatment modalities may be effective alternatives as indicated by an American national survey which showed that 17.5% of people with serious mental health concerns sought self-help for their emotional problems (Wang et al., 2000). The purpose of the present study was to examine the frequency and types of self-help behaviours that are being used by Canadians and to examine some possible predictors of Internet-based self-help use using a nationally representative sample.Self-help has traditionally been defined as self-help groups, books, and telephone helplines, and the last decade has also seen an increase in self-help offered over Internet-based services. Self-help has been included and recommended in clinical practice guidelines for psychiatric disorders such as anxiety and depression (Canadian Psychiatric Association, 2006; Lam et al., 2009); however, there is still a lack of high-quality research in this area. There are several challenges inherent in studying self-help, namely the prevalence of low-quality evidence and the difficulty of obtaining an accurate estimate of self-help utilization. While few studies examine self-help service use, several systematic reviews investigating efficacy of self-help for anxiety and depression found preliminary evidence of effectiveness with the caveat that the quality of most outcomes were low and contained considerable risk of bias (Bower, Richards, & Lovell, 2001; Cuijpers, Donker, Van Straten, Li, & Andersson, 2010; Van't Hof, Cuijpers, & Stein, 2009).The majority of the literature which examines telephone helplines is within the context of smoking cessation, rather than mental health problems. However, recent systematic reviews indicate that the use of such helplines was associated with greater smoking cessation rates (Civljak, Stead, Hartmann-Boyce, Sheikh, & Car, 1996; Stead, Hartmann-Boyce, Perera, & Lancaster, 2013). A small body of literature examining anxiety and depression in the context of physical health problems does provide evidence that utilization of telephone helplines may be associated with reductions in depression and anxiety (e.g., Veazey, Cook, Stanley, Lai, & Kunik, 2009; White et al., 2012). With respect to self-help groups, these studies can be methodologically poor, and often measure attendance rather than participation (Kelly, 2003). Despite the evidence indicating that self-help may be an effective method for mental health treatment, there is no research to date which provides sociodemographic predictors of self-help service utilization. Therefore, one of the aims of the present study was to address this gap and present predictors of self-help utilization using a large Canadian sample.Internet-Based Self-HelpIn our increasingly connected lives, Internet-based self-help is gaining traction as a viable treatment for mental health concerns. This has been recognised by the Canadian government, and in 2014, the Mental Health Commission of Canada released the document E-Mental Health in Canada: Transforming the Mental Health System Using Technology. This document outlines recommendations related to improving the visibility and informing the further development of technology-based mental health services to increase access to care (Mental Health Commission of Canada, 2014). …