title: Reasons and Determinants for Perceiving Unmet Needs for Mental Health in Primary Care in Quebec.
abstract: OBJECTIVE
  To evaluate the mental health care needs perceived as unmet by adults in Quebec who had experienced depressive and (or) anxious symptomatology (DAS) in the previous 2 years and who used primary care services, and to identify the reasons associated with different types of unmet needs for care (UNCs) and the determinants of reporting UNCs.
  
  
  METHODS
  Longitudinal data from the Dialogue Project were used. The sample consisted of 1288 adults who presented a common mental disorder and who consulted a general practitioner. The Hospital Anxiety and Depression Scale was used to measure DAS, and the Perceived Need for Care Questionnaire facilitated the assessment of the different types of UNCs and their motives.
  
  
  RESULTS
  About 40% of the participants perceived UNCs. Psychotherapy, help to improve ability to work, as well as general information on mental health and services were the most mentioned UNCs. The main reasons associated with reporting UNCs for psychotherapy and psychosocial interventions are "couldn't afford to pay" and "didn't know how or where to get help," respectively. The factors associated with mentioning UNCs (compared with met needs) are to present a high DAS or a DAS that increased during the past 12 months, to perceive oneself as poor or to not have private health insurance.
  
  
  CONCLUSIONS
  To reduce the UNCs and, further, to reduce DAS, it is necessary to improve the availability and affordability of psychotherapy and psychosocial intervention services, and to inform users on the types of services available and how to access them.
authors.affiliation: Post-doctoral Fellow, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec; Post-doctoral Fellow, Département de médecine sociale et préventive, Université de Montréal, Montreal, Quebec; Post-doctoral Fellow, Institut National de Santé Publique du Québec, Montreal, Quebec; Post-doctoral Fellow, Département des sciences de la santé communautaire, Centre de recherche-Hôpital Charles-Le Moyne, Campus de Longueuil - Université de Sherbrooke, Sherbrooke, Quebec.
authors.forename: Anne
authors.initials: A
authors.lastname: Dezetter
authors.affiliation: Assistant Professor, Faculté des Sciences Infirmières de l'Université de Montréal, Université de Montréal, Montreal, Quebec.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Duhoux
authors.affiliation: Post-doctoral Fellow, Département de médecine familiale et de médecine d'urgence, Université Laval, Quebec, Quebec.
authors.forename: Matthew
authors.initials: M
authors.lastname: Menear
authors.affiliation: Assistant Professor, Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, Quebec.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Roberge
authors.affiliation: Research Assistant, Institut National de Santé Publique du Québec, Montreal, Quebec.
authors.forename: Elise
authors.initials: E
authors.lastname: Chartrand
authors.affiliation: Researcher, Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec; Full Professor, Département de médecine sociale et préventive, Université de Montréal, Montreal, Quebec.
authors.forename: Louise
authors.initials: L
authors.lastname: Fournier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000628:therapy*; D003863:Depression / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data*; D011792:Quebec; D055815:Young Adult