HELP-SEEKING FOR PSYCHIATRIC-DISORDERS

Objective: To examine demographic and clinical determinants of seeking help for mental or emotional problems. To determine the proportion of those people with a disorder who sought help. To determine what categ ories of professionals are sought by those who get care. Method: A 2-s tage random sample of 3956 adult residents of Edmonton, Alberta, Canad a was interviewed by trained lay interviewers using the Diagnostic Int erview Schedule (DIS) (73% completion rate). An average of 2.8 years l ater, a systematic random sample of 1964 subjects was reinterviewed (a n 86% completion rate) using the DIS and a health care utilization que stionnaire. After adjusting for age and sex, the reinterview sample wa s representative of those with and without a diagnosis at the first in terview Results: Of the 1964 subjects, 570 (31%) met criteria for a DI S/DSM-III diagnosis in the year preceding the interview (one-year prev alence rate). These diagnoses included generalized anxiety disorder (G AD) and posttraumatic stress disorder (PTSD). For those with a diagnos is, sex, age, marital status, education, employment and income were ex amined as determinants of help-seeking. Only sex (female) and age (und er 45) were significant predictors. Comorbidity was highly significant : the help-seeking rate for those with one diagnosis was 20.3%;for tho se with more than one diagnosis, the rate was 42.8% (OR = 2.94, chi(2) = 31.4, df = 1, P < 0.001). Just over 28% of those with a diagnosis s aw any health care professional, and 7.7% of those without a diagnosis sought help for a mental or emotional problem. A specific diagnosis m ade a difference. 46.7% of those with a major depressive episode sough t help, but only 16.0% of those with alcohol abuse or dependence sough t cave. Conclusion: Major determinants of help-seeking are sex (female ), age (under 45), severity of the illness, and comorbidity. A surpris ingly high proportion of those with a disorder (72%) do not seek help, and over one-third of those seeking help do not have a current DIS/DS M-III disorder.