What makes people decide who to turn to when faced with a mental health problem? Results from a French survey.
BACKGROUND
The unequal use of mental health care is a great issue, even in countries with universal health coverage. Better knowledge of the factors that have an impact on the pathway to mental health care may be a great help for designing education campaigns and for best organizing health care delivery. The objective of this study is to explore the determinants of help-seeking intentions for mental health problems and which factors influence treatment opinions and the reliance on and compliance with health professionals' advice.


METHODS
441 adults aged 18 to 70 were randomly selected from the general population of two suburban districts near Paris and agreed to participate in the study (response rate = 60.4%). The 412 respondents with no mental health problems based on the CIDI-SF and the CAGE, who had not consulted for a mental health problem in the previous year, were asked in detail about their intentions to seek help in case of a psychological disorder and about their opinion of mental health treatments. The links between the respondents' characteristics and intentions and opinions were explored.


RESULTS
More than half of the sample (57.8%) would see their general practitioner (GP) first and 46.6% would continue with their GP for follow-up. Mental health professionals were mentioned far less than GPs. People who would choose their GP first were older and less educated, whereas those who would favor mental health specialists had lower social support. For psychotherapy, respondents were split equally between seeing a GP, a psychiatrist or a psychologist. People were reluctant to take psychotropic drugs, but looked favorably on psychotherapy.


CONCLUSIONS
GPs are often the point of entry into the mental health care system and need to be supported. Public information campaigns about mental health care options and treatments are needed to educate the public, eliminate the stigma of mental illness and eliminate prejudices.
MGEN Foundation for Public Health, EA 4069 University of Paris 5, 3 square Max Hymans, 75748 Paris Cedex 15, France. vkovess@mgen.fr
Viviane
V
Kovess-Masféty
Delphine
D
Saragoussi
Christine
C
Sevilla-Dedieu
Fabien
F
Gilbert
Agnieszka
A
Suchocka
Nathalie
N
Arveiller
Isabelle
I
Gasquet
Nadia
N
Younes
Marie-Christine
MC
Hardy-Bayle
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003657:Decision Making; D004522:Educational Status; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D033182:Intention; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010297:Paris; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011570:Psychiatry / Q000706:statistics & numerical data*; D011586:Psychology, Clinical / Q000706:statistics & numerical data*; D013383:Suburban Population; D011795:Surveys and Questionnaires