Who uses psychological services in Canada?

Abstract

AbstractUsing data collected by Statistics Canada in the 1994-1995 Population Health Survey, we provide a profile of consumers of psychological services. Approximately 2.15% of those surveyed indicated that they had consulted a psychologist in the 12 months prior to the survey; in population estimates, this is equivalent to 515,000 Canadians. The demographic profile of consumers of psychological services is consistent with patterns of utilization of mental health services found in other studies. That is, consumers were more likely to be female, to be middle- aged and to be separated, divorced or widowed. Those with higher education and higher income were more likely to receive psychological services. Consumers of psychological services reported poorer health status than the general population, a higher number of past and recent stressors, higher levels of distress, and were more likely to have received psychotropic medication. However, the majority of those likely to meet criteria for a diagnosis of depression did not receive psychological services. Another important theme emerging from the study was the apparent underutilization of psychological services, especially by those Canadians with the greatest mental health needs.In Canada, there are over 10,000 licensed psychologists who practise in a variety of settings including hospitals, mental health centres, and private practices (Adair, Paivio, & Ritchie, 1996). Psychologists offer diverse services, including assessment, intervention, and consultation, basing their practices on a range of theoretical models (Hunsley & Lefebvre, 1990). Although we have a general sense of who practices psychology and what psychological services they offer, less is known about the recipients of psychological services. It is important to develop a profile of those who receive psychological services and those who do not, as such a profile could provide useful information for such diverse stakeholders as policy-makers, planners, service providers, and the Canadian public.Epidemiological surveys of mental health problems and users of mental health services allow an examination of the fit between service needs and actual service provision (Lin, Goering, Offord, Campbell, & Boyle, 1996; Vessey & Howard, 1993). The Ontario Mental Health Survey (Lin et al., 1996; Offord et al., 1996) was a province-wide survey of 9,953 households examining the prevalence of mental disorders and use of services for mental health reasons in the province of Ontario. In addition to diagnostic interviews, participants were asked questions about their hospital admission, contact with professionals, or use of other services because of problems with their emotions, nerves, or use of alcohol or drugs. Professionals included general and specialty physicians, psychologists, social workers, nurses, occupational therapists, clergy, spiritualists, herbalists, and faith healers.Lin et al. reported that among participants aged 15-64, 7.8% had sought services for mental health reasons over the previous year. Psychologists were seen by 10% of those seeking help. The strongest predictors of mental health service use were being female, being separated, divorced or widowed, receiving public assistance, and having a diagnosable mental disorder. Predictors of service use were not presented separately for each professional group, so it is not possible to determine whether the patterns of usage differed among professions. Although the presence of a diagnosable mental disorder was a strong predictor of receiving mental health services, the majority of those with mental disorders did not seek mental health services (Ontario Ministry of Health, 1994).Vessey and Howard (1993) presented data from epidemiological surveys in the United States of people who make mental health visits and who receive psychotherapy. They reported that about two-thirds of outpatients were women, around half had a college education, about half were married, and the majority were in the 21-50 age range. …