Examining the mental health services among people with mental disorders: a literature review

Summary & key facts

Researchers looked at studies from 2012 to 2023 that examined who with mental disorders actually uses mental health services and what stops people from getting care. They combined about 40 studies from high-income countries and found that people who are middle-aged, women, white, and from higher-income households were more likely to get mental health care. Serious symptoms made people more likely to seek care, while high costs, poor transport, too few services, stigma, and cultural beliefs made people less likely to get help. The review points out clear gaps and inequalities in who gets care, which is useful for planning fairer services.

Key facts:

• The review looked at about 40 studies published between 2012 and 2023 that sampled the general population in high-income countries.
• Most studies were snapshot studies that measured people at one point in time rather than following them over years.
• People who were middle-aged, women, white, and from higher-income households were more likely to use mental health services.
• Having more severe mental symptoms was linked to a higher chance of using services.
• There is a large treatment gap: only about 40 to 45 out of every 100 people with mental illness seek help from a professional service.
• Structural barriers linked to lower use of services included high treatment costs, lack of transport, and too few mental health services available.
• Attitudes also mattered: stigma, fear of being judged, low awareness of mental illness, and cultural beliefs were commonly reported reasons people did not seek care.
• The studies varied a lot in size. One large study from Canada included millions of people, while other studies had only a few hundred participants.
• The reviewers checked study quality and noted differences across the papers, so the strength of evidence varied from study to study.
• Results for whether employment or marital status affected service use were mixed and unclear because there were too few consistent findings.

Abstract

This systematic review found that several socio-demographic characteristics were strongly associated with using mental health services. Policymakers and those providing mental health services can use this information to better understand and respond to inequalities in mental health service use and improve access to mental health treatment.

Topics

Family Caregiving in Mental Illness Mental Health Treatment and Access Schizophrenia research and treatment

Categories

Psychology Social Psychology Social Sciences

Tags

Classification of mental disorders Clinical psychology Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Medicine Mental health Mental health service Prevalence of mental disorders Psychiatry Psychological intervention Psychology

Conditions & symptoms

Anxiety Depression Anxiety or worry Lack of energy or motivation Poor sleep Sadness or low mood