Education Level, Income Level and Mental Health Services Use in Canada: Associations and Policy Implications

Abstract

Background: Investigations of socio-economic gradients in mental health services use in Canada have used different measures of socio-economic status and have shown conflicting results. We explored the relationships between education level, income level and mental health services use among people with a mental illness using data from the Canadian Community Health Survey: Cycle 1.2. Methods:We included adults who met the criteria for an anxiety or depressive disorder in the past 12 months (n=3,101). We calculated the likelihood of seeking mental healthcare from a psychiatrist, psychologist, family physician or social worker over a period of 12 months by education level. Results:For each additional level of education, individuals were 15% more likely to see a psychiatrist, 12% more likely to see a family doctor, 16% more likely to see a psychologist and 16% more likely to see a social worker. Discussion/Conclusion:We found marked inequity in mental health services use by education level that was consistent across service types. Programs aiming to deliver targeted services to consumers who have not completed high school should be developed and evaluated. RésuméContexte : Les enquêtes sur les gradients socio-économiques dans l'utilisation des services de santé mentale au Canada ont utilisé différentes mesures du statut socioéconomique et ont donné des résultats contradictoires. Nous avons exploré les relations entre le niveau de scolarité, le niveau de revenu et l'utilisation des services de santé mentale chez les personnes atteintes d'une maladie mentale en utilisant les données de l'Enquête sur la santé dans les collectivités canadiennes : Cycle 1.2.Méthodes : Nous avons inclus des adultes qui répondaient aux critères de troubles anxieux ou dépressifs au cours des 12 derniers mois (n=3,101). Nous avons calculé la probabilité de chercher des soins de santé mentale auprès d'un psychiatre, d'un psychologue, d'un médecin de famille ou d'un travailleur social sur une période de douze mois, selon le niveau de scolarité. Résultats : Pour chaque niveau de scolarité supplémentaire, les répondants étaient 15 % plus susceptibles de consulter un psychiatre, 12 % plus susceptibles de s' adresser à un médecin de famille, 16 % plus susceptibles de faire appel à un psychologue et 16 % plus susceptibles de recourir à un travailleur social.Discussion/Conclusion : Nous avons constaté d'importantes inégalités dans l'utilisation des services de santé mentale par niveau de scolarité, et ces inégalités étaient constantes dans tout le secteur des services. On devrait élaborer et évaluer des programmes visant à fournir des services ciblés aux consommateurs qui n' ont pas terminé leurs études secondaires. T BackgroundMental and behavioural disorders are common, universal and disabling. The economic burden of mental illness places it among the costliest conditions in Canada.Stephens and Joubert (2001) estimated the direct and indirect costs of depression and distress to be over 14 billion dollars. Recent Canadian data have shown that...

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