“I don’t need any treatment” – barriers to mental health treatment in the general population of a megacity

Abstract

Objective: Most countries fail to treat individuals with psychopathologies. Investigating treatment barriers and reasons for dropout are key elements to overcoming this scenario. Methods: A representative sample of 2,942 urban-dwelling adults was interviewed face-to-face within a cross-sectional, stratified, multistage probability survey of the general population. Psychiatric diagnosis, severity level, use of services, reasons for not seeking treatment, and treatment dropout were investigated. Results: Only 23% of individuals with a psychopathology of any severity level in the last 12 months received treatment. Low perceived need for treatment (56%) was the most common reason for not seeking treatment. The most visited settings were psychiatric, other mental health care, and general medical care. Among those with a perceived need for treatment (44%), psychological barriers were the most common reason for not seeking it. Treatment dropout was more prevalent among those who visited a general medical care setting. Among individuals still in treatment, human services and psychiatric care were the most common types. Female sex was associated with structural barriers (OR = 2.1). Disorder severity was negatively associated with need barriers (OR = 0.4), and positively associated with structural barriers (OR = 2.5) and psychological barriers (OR = 2.5). Conclusion: Despite the need for treatment and better services, psychological barriers were the major reason for not seeking treatment. Apart from providing more specialists, investing in awareness, de-stigmatization, and information is the ultimate strategy for improving psychiatric care.

Experiences of alcohol-dependent elderly: grounded theory

“…Therefore, among the interviewed elderly who maintain excessive alcohol consumption, they fail to recognize the disease or present a desire to change. The lack of perception of the need for treatment is a complex behavior, related to personal attitudes and beliefs and social patterns that negatively influence the search for assistance (19) .…”

“…Excessive alcohol consumption is one of the major risk factors for the development of a number of health problems. Such conditions may be exacerbated in the case of older adults with poor physical health and who take medications that may interact with alcohol (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) .…”

Vivências de idosos dependentes de álcool: teoria fundamentada nos dados

“…Assim, entre os idosos entrevistados que mantêm o consumo excessivo de álcool, não reconhecem a doença ou apresentam desejo de mudança. A ausência de percepção da necessidade de tratamento é um comportamento complexo, relacionado a atitudes e crenças pessoais e padrões sociais que influenciam negativamente a busca por assistência (19) .…”

“…O consumo excessivo de álcool é apontado como um dos principais fatores de risco para o desenvolvimento de uma série de problemas de saúde. Tais condições podem se agravar no caso de idosos com saúde física debilitada e que fazem uso de medicamentos que podem ter interação com o álcool (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) .…”

Digital mental health interventions for school teachers – A narrative review

“…Despite other barriers to mental health care-such as the lack of structure, personnel and financial resources-overcoming mental health stigma is a major challenge (Coêlho et al, 2021). Therefore, identifying individuals in need entails investing in awareness and literacy, which may be the first step towards mental health promotion (Jorm, 2012).…”