Unmet Need for Mental Healthcare in a Population Sample in Sweden: A Cross-Sectional Study of Inequalities Based on Gender, Education, and Country of Birth

Sara Olsson,Gunnel Hensing,Bo Burström,Jesper Löve

doi:10.1007/s10597-020-00668-7

Sara Olsson, Gunnel Hensing + Show 2 more

Open Access

https://doi.org/10.1007/s10597-020-00668-7

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Abstract

This cross-sectional study investigated if gender, education, and country of birth were associated with perceived need and unmet need for mental healthcare (i.e., refraining from seeking care, or perceiving care as insufficient when seeking it). Questionnaire and register data from 2008 were collected for 3987 individuals, aged 19–64 years, in a random population-based sample from western Sweden. Descriptive statistics and logistic regression analyses were used. Men were less likely to perceive a need for care than were women, even after adjusting for mental well-being. Men were also less likely to seek care and perceiving care as sufficient. People with secondary education were less likely to seek care than those with university education. There were no statistically significant differences based on country of birth. The observed gender and education-based inequalities increases our understanding of where interventions can be implemented. These inequalities in unmet need for mental healthcare should be targeted by the healthcare system.

Highlights

Despite the high prevalence of common mental disorders such as depression and anxiety disorders in high-income countries, many of those affected do not seek care (Alonso et al 2004; Forsell 2006; Johansson et al 2013; Kessler et al 2003; Mojtabai 2009; Mojtabai and Olfson 2006; Wallerblad et al 2012) or do not perceive that they have receivedThe definition of need for mental healthcare is debated (Bebbington et al 1997)
This study investigated if social positions, using gender, education, and country of birth as indicators, were associated with perceived need and unmet need for mental healthcare in a Swedish population-based sample
To investigate the associations between social positions and the three outcomes, logistic regression analyses were conducted by calculating odds ratios (ORs) and 95% confidence intervals (CIs)

Summary

Introduction

Despite the high prevalence of common mental disorders such as depression and anxiety disorders in high-income countries, many of those affected do not seek care (Alonso et al 2004; Forsell 2006; Johansson et al 2013; Kessler et al 2003; Mojtabai 2009; Mojtabai and Olfson 2006; Wallerblad et al 2012) or do not perceive that they have receivedThe definition of need for mental healthcare is debated (Bebbington et al 1997). Studies have identified a discrepancy between “clinical need” and “perceived need” for mental healthcare since not all individuals with a clinical need for care report any such perceived need (Forsell 2006; Meadows et al 2000). This may be because many of those fulfilling diagnostic criteria for common mental disorders may not require healthcare treatment (Sareen et al 2013; Vigo et al 2016) since most of them have mild to moderate conditions (Kessler et al 2012; OECD 2012). Even milder conditions may worsen, and they are associated with lower productivity at workplaces, higher absenteeism, and unemployment (Hewlett and Moran 2014)

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