Abstract
BackgroundPsychological interventions (PIs) are good practice treatment for both subthreshold and diagnosed mental disorders. Australia has implemented major reforms to expand the provision of subsidised psychological services for individuals with a diagnosed mental disorder. But there are gaps in knowledge about demand for PIs (i.e., use of and perceived need for PIs) across the population. This study uses nationally representative survey data from the 2007 Australian National Survey of Mental Health and Wellbeing to analyse demand for PIs. It also provides a method for analysing survey data to estimate demand for PIs when new survey data becomes available, along with suggestions to inform future survey development.MethodsNationally representative community survey respondents (n = 8841, 16–85 years) indicated their perceived need for nine types of help for mental health problems in the past 12 months, including three PIs (cognitive behavioural therapy, psychotherapy, and counselling), and whether these needs were unmet, partially met, or fully met. Types of help were grouped as: PIs only; PIs plus other; and other only. Chi-square analyses were used to examine the association between type of intervention, sociodemographic and clinical factors, and type of professional consulted; multinomial logistic regression models were used to examine predictors of type of intervention(s) received. Results7.9% (95%CI: 7.2–8.6) received PIs. Receipt of PIs was positively associated with higher education and consulting a mental health specialist. Twice as many respondents received PIs plus medication as compared to PIs only (4.2% vs. 2.0%). Almost half (45.4, 95%CI 36.5–54.6) incurred out-of-pocket costs for treatment. The most common reason for partially met need for PIs was cost (24.8, 95%CI 17.2–34.3); for unmet need, it was preference for self-management (33.9, 95%CI 21.2–49.5). Perceived unmet need for PIs only (3.1, 95%CI 2.1–4.6) or PIs plus other interventions (5.2, 95%CI 3.9–6.9%) was lower than for other interventions only (22.8, 95%CI 18.7–27.6).ConclusionsContinued reforms in Australia means that on-going monitoring of demand for PIs, using nationally representative data, is required. This study provides a baseline for comparison of the long-term effects of these reforms; this comparison may be undertaken using data from the third iteration of Australia’s NSMHWB, due for completion in 2021–22.
Highlights
Psychological interventions (PIs) are good practice treatment for both subthreshold and diagnosed mental disorders
Receipt of psychological interventions In 2007, 7.9% of Australians received PIs in the past year, representing around two-thirds of those who received help for mental health problems. Of those receiving PIs, almost twice as many received counselling compared to cognitive behavioural therapy (CBT) or psychotherapy
Receipt of PIs plus other interventions was more common than receipt of PIs only or other interventions only
Summary
Psychological interventions (PIs) are good practice treatment for both subthreshold and diagnosed mental disorders. Practice guidelines promote PIs as first-line treatments for subthreshold and diagnosed mental disorders [2,3,4,5]. In the United States from 1987 to 2007, receipt of psychotherapy in the general population was stable but the number of consultations per person declined, while the use of psychopharmacological treatments increased. This likely reflected the promotion of medications and financial disincentives to providing psychotherapy at this time [7, 8]. In Canada, unmet need for PIs in 2002 was higher than other types of treatment [10], possibly because primary-care physicians are the most common providers of care and are better able to meet need for medication than PIs
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