Variables Associated With Perceived Unmet Need for Mental Health Care in a Canadian Epidemiologic Catchment Area.
OBJECTIVE
This study identified variables associated with perceived partially met and unmet needs for information, medication, and counseling, as well as overall perceived unmet needs, related to mental health among 571 people in a Canadian epidemiologic catchment area.


METHODS
Needs were measured with the Perceived Need for Care Questionnaire and a comprehensive set of independent variables based on Andersen's behavioral model. Four models were constructed for the following dependent variables: perceived unmet needs for information, medication, and counseling (multinomial logistic regression) and overall perceived unmet needs (multiple logistic regression).


RESULTS
The proportions reporting fully unmet need were as follows: counseling, 30%; information, 18%; and medication, 4%. Variables associated with unmet needs for information, medication, and counseling were quite distinct. Enabling factors (for example, neighborhood perception variables) were strongly associated with perceived unmet need for information. Need factors were more strongly associated with unmet need for medication, predisposing factors with unmet needs for information and medication, and health service use with unmet information and counseling needs. People whose overall needs went unmet tended to be younger, to have an addiction, and to have consulted fewer professionals.


CONCLUSIONS
Mental health services should facilitate access to psychologists or other clinicians to better meet counseling and information needs. They should also take neighborhoods into account when assessing needs and provide more information about mental disorders and the treatments and services offered in disadvantaged areas. Finally, services should be further developed for younger people with addiction, who tend to be stigmatized and avoid using health services.
Dr. Fleury and Dr. Caron are with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (e-mail: flemar@douglas.mcgill.ca ). Dr. Grenier, Dr. Bamvita, and Dr. Perreault are with the Douglas Mental Health University Institute, Montreal.
Marie-Josée
MJ
Fleury
Dr. Fleury and Dr. Caron are with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (e-mail: flemar@douglas.mcgill.ca ). Dr. Grenier, Dr. Bamvita, and Dr. Perreault are with the Douglas Mental Health University Institute, Montreal.
Guy
G
Grenier
Dr. Fleury and Dr. Caron are with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (e-mail: flemar@douglas.mcgill.ca ). Dr. Grenier, Dr. Bamvita, and Dr. Perreault are with the Douglas Mental Health University Institute, Montreal.
Jean-Marie
JM
Bamvita
Dr. Fleury and Dr. Caron are with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (e-mail: flemar@douglas.mcgill.ca ). Dr. Grenier, Dr. Bamvita, and Dr. Perreault are with the Douglas Mental Health University Institute, Montreal.
Michel
M
Perreault
Dr. Fleury and Dr. Caron are with the Department of Psychiatry, McGill University, Montreal, Quebec, Canada (e-mail: flemar@douglas.mcgill.ca ). Dr. Grenier, Dr. Bamvita, and Dr. Perreault are with the Douglas Mental Health University Institute, Montreal.
Jean
J
Caron
D000328:Adult; D002170:Canada / Q000453:epidemiology; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D020380:Needs Assessment; D011795:Surveys and Questionnaires