title: Does having a chronic physical condition affect the likelihood of treatment seeking for a mental health problem and does this vary by ethnicity?
abstract: OBJECTIVE
  The comorbidity of mental disorders with chronic physical conditions is known to have important clinical consequences, but it is not known whether mental-physical comorbidity influences mental health treatment seeking. This study investigates whether the presence of a chronic physical condition influences the likelihood of seeking treatment for a mental health problem, and whether that varies among ethnic subgroups in New Zealand.
  
  
  METHODS
  Analyses were based on a subsample (n = 7,435) of The New Zealand Mental Health Survey, a nationally representative household survey of adults (response rate 73.3%). Ethnic subgroups (Maori and Pacific peoples) were oversampled. DSM-IV mental disorders were measured face-to-face with the Composite International Diagnostic Interview (CIDI 3.0). Ascertainment of chronic physical conditions was via self-report.
  
  
  RESULTS
  In the general population, having a chronic medical condition increased the likelihood of seeking mental health treatment from a general practitioner (OR: 1.58), as did having a chronic pain condition (OR: 2.03). Comorbid chronic medical conditions increased the likelihood of seeking mental health treatment most strongly among Pacific peoples (ORs: 2.86-4.23), despite their being less likely (relative to other ethnic groups) to seek mental health treatment in the absence of physical condition comorbidity.
  
  
  CONCLUSIONS
  In this first investigation of this topic, this study finds that chronic physical condition comorbidity increases the likelihood of seeking treatment for mental health problems. This provides reassurance to clinicians and health service planners that the difficult clinical problem of mental-physical comorbidity is not further compounded by the comorbidity itself constituting a barrier to mental health treatment seeking.
authors.affiliation: Department of Psychological Medicine, University of Otago, Dunedin, New Zealand. kate.scott@otago.ac.nz
authors.forename: K M
authors.initials: KM
authors.lastname: Scott
authors.forename: J
authors.initials: J
authors.lastname: Kokaua
authors.forename: J
authors.initials: J
authors.lastname: Baxter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000208:ethnology* / Q000523:psychology*; D059350:Chronic Pain / Q000208:ethnology / Q000523:psychology; D015897:Comorbidity; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D058006:General Practice; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D009042:Motivation; D009520:New Zealand; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology*; D055815:Young Adult