title: Group differences in outpatient help-seeking for psychological distress: results from a national prospective study of Icelanders.
abstract: OBJECTIVE
  This study focused on group differences in health care use for psychological distress. Specifically, the study examined if some subgroups and kinds of distress predicted use of particular providers.
  
  
  METHODS
  The study uses data from a repeated national postal health survey of a random sample of Icelanders aged 18-75. Response rate at the first wave was 69% (n = 1924), and 83% of the participants from the first wave also responded to the second. The dependent variables referred to use of outpatient visits to different types of professionals (doctor, psychiatrist, registered nurse, psychologist, social worker, clergy, and complementary and alternative medicine provider).
  
  
  RESULTS
  Gender, age, marital status, residence, education and income affected the selection of healthcare provider. Significant interactions indicated, among other things, that divorced people made the most visits to psychiatrists when depressed, that urban residents visited psychiatrists and psychologists more than others when experiencing anxiety, that the university-educated visited psychologists more when depressed, and that individuals with higher incomes visited psychiatrists, nurses and social workers less when experiencing anxiety or depression.
  
  
  CONCLUSIONS
  Results indicate considerable group variations in help-seeking. The group in question and the nature of symptoms affected the decision where to seek help. A substantial number of distressed individuals do not seek any professional help, and there are indications of inequity in the distribution of health services. Further studies are needed to better understand the complex social selection processes involved in seeking help for psychological problems.
authors.affiliation: The Public Health Institute, Laugavegur 116, Reykjavik, Iceland.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Gudmundsdottir
authors.forename: Runar
authors.initials: R
authors.lastname: Vilhjalmsson
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult