Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders.
OBJECTIVE
To investigate the prevailing attitudes towards mental health help-seeking in Europe, their correlates, and whether these attitudes are associated with actual service use for mental health problems.


METHODS
Data were derived from the European Study of Epidemiology of Mental Disorders, a survey representative of the adult population of six countries: Belgium, France, Germany, Italy, the Netherlands and Spain (n = 8,796). The World Mental Health Composite International Diagnostic Interview was used to assess attitudes and DSM-IV diagnoses. The attitudes referred to beliefs that the respondents would seek professional help when faced with a serious emotional problem, would feel comfortable talking about personal problems with a professional, would not be embarrassed if friends knew about the professional help, and respondents' perceived effectiveness of mental health care.


RESULTS
Almost a third of the respondents held the view that professional care was worse than or equal to no help when faced with serious emotional problems. Female gender, being younger than 65 years of age, high income, living in Spain or Italy, presence of mood disorder and previous service use were associated with at least two of the four assessed attitudes towards mental health help-seeking. All four attitudes were significantly associated with mental health care use, also after adjustment for previous service use.


CONCLUSIONS
The low perceived effectiveness of professional care calls for serious action aiming to improve the visibility and credibility of the mental health care sector.
ten Have
M
M
Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS, Utrecht, The Netherlands. mhave@trimbos.nl
de Graaf
R
R
Ormel
J
J
Vilagut
G
G
Kovess
V
V
Alonso
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011639:Public Opinion; D011788:Quality of Life; D011795:Surveys and Questionnaires