Do Canada and the United States Differ in Prevalence of Depression and Utilization of Services?

Despite the rapid growth of the Latino population in the child welfare system and the high rate of mental health need among children involved with this system, little is known about the mental health needs or use of mental health services among Latino children of immigrants involved with this system. Further, little is known about how the need for mental health services or use of those services differs from children of U.S.-born Latinos. This study analyzes data from the National Survey of Child and Adolescent Well-being (NSCAW) to identify the need for mental health services, mental health service use, and unmet mental health needs among Latino children of immigrants involved in the child welfare system, and compares those factors to those of children in U.S.-born Latino families. Findings indicate that significant differences are present, both in the need for mental health services and the use of those services. Awareness of these differences is necessary to effectively respond to the unique needs and experiences of Latino immigrant children and families who come to the attention of the child welfare system.

Influence of caregiver network support and caregiver psychopathology on child mental health need and service use in the LONGSCAN study

Mental Health Services Use and Symptom Prevalence in a Cohort of Adults on Probation

Limited English proficiency as a barrier to mental health service use: A study of Latino and Asian immigrants with psychiatric disorders

Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

Children with special healthcare needs (CSHCN), especially those with mental health needs, often receive services from multiple service sectors, including schools. Thus, care coordination may play a critical role in access to mental health care for these children. This pooled cross-sectional study used multivariable logistic regression with data from the National Survey of Children’s Health (2020–2023), focusing on a subsample of children with caregiver-reported mental health problems and need for mental healthcare. It estimates the prevalence of parent-reported need for and receipt of effective care coordination and provider communication with schools. It also measures the association between parent-reported receipt of these services with unmet need for mental healthcare. Most caregivers reported need for care coordination (51.3%) and provider communication with schools (60.7%). Among those with need, 48.3% reported not having their care coordination needs met, and 57.2% of families reported unmet need for provider communication with schools. The probability of reported unmet mental health needs was 12 percentage points lower when children had all needs for care coordination met and 10 points lower when providers communicated with schools. Results suggest that having care coordination needs met and provider communication with schools may play an important role in children accessing needed mental healthcare.

To examine the unmet needs for mental health and substance use treatment among a diverse sample of sexual minority women (lesbian, bisexual). Sexual minority women are more likely than heterosexual women to report depression and hazardous drinking. However, relatively little is known about sexual minority women's use of mental health or substance use treatment services, particularly about whether use varies by race/ethnicity. Cross-sectional analysis of existing data. Analyses included data from 699 Latina, African American and white sexual minority women interviewed in wave 3 of the 17-year Chicago Health and Life Experiences of Women study. Using logistic regression, we examined the associations among sexual identity, race/ethnicity, use of mental health and substance use treatment, as well as potential unmet need for treatment. Overall, women in the study reported high levels of depression and alcohol dependence, and these varied by sexual identity and race/ethnicity. Use of mental health and substance use treatment also varied by race/ethnicity, as did potential unmet need for both mental health and substance use treatment. Our findings that suggest although use of treatment among sexual minority women is high overall, there is a potentially sizable unmet need for mental health and substance use treatment that varies by race/ethnicity, with Latina women showing the greatest unmet need for treatment. Nurses and other healthcare providers should be aware of the high rates of depression and hazardous drinking among sexual minority women, understand the factors that may increase the risk of these conditions among sexual minority women, the potentially high unmet need for mental health and substance use treatment - perhaps particularly among Latina women and be equipped to provide culturally sensitive care or refer to appropriate treatment services as needed.

County-Level Estimates of Need for Mental Health Professionals in the United States

BackgroundSelf‐reported psychotic experiences (PEs) are associated with psychopathology of all kinds, not just psychoses. However, systematic reviews on the relevance of this for health services are unavailable. Furthermore, whether association with service use is confounded by other psychopathology is unknown, and is relevant to prevention and treatment.ObjectivesLiterature examining associations between PEs and service use was systematically reviewed. Study quality and the direction and extent of any associations were assessed, and meta‐analysis conducted.MethodsSystematic review and meta‐analysis was carried out as per PRISMA guidelines. A search of electronic databases was performed based on free‐text and structured terms. Included studies were evaluated by two raters using a structured tool and estimates extracted for reporting.ResultsThirteen studies were returned. We found two prospective studies, and a minority of studies accounted for concurrent psychopathology, limiting our ability to test our main hypotheses. Five studies reported associations by different types of service use. Almost all studies assessed service use by self‐report. Meta‐analysis suggested that people who reported PEs were around twice as likely to report service use compared to those who did not (pooled OR for all included studies: 2.20,95% confidence intervals (95%CI): 1.66,2.91).ConclusionsThere was consistent evidence of association between PEs and mental health service use at the general population level. However, evidence for causation was poor due to a limited number of studies. Whether increased service use in this group is solely attributable to PEs, and therefore whether interventions aimed at limiting/preventing PEs might be effective, requires studies focusing on the relationships between PEs, psychopathology and service use.

Parents of children with long-term emotional or behavioral conditions often struggle to access and afford mental health services for their children.This article examines the parent-reported reasons for unmet mental health needs in children using the National Survey of Children with Special Health Care Needs, specifically investigating whether insurance status (insured versus uninsured) and insurance type (private versus public) influences why a child has an unmet mental health need. The sample included children whose parents reported a need for mental health care or counseling in the previous 12 months, focusing on children with long-term emotional/behavioral problems rather than children experiencing episodic events that might only require short-term mental health services. Findings indicate that being uninsured increases the likelihood of parents reporting costs too much as the reason for their child having unmet mental health needs, whereas being insured by public health insurance decreases the likelihood of reporting costs too much as the reason. Policy implications include the need for expansion of health insurance coverage for all children and the need to achieve parity for mental health benefits in private health insurance.

There is limited empirical evidence on the extent to which perceived public stigma prevents individuals from using mental health services, despite substantial recent policy interest in this issue. This study investigated associations between perceived public stigma and mental health care seeking. This study used cross-sectional survey data from a representative sample of undergraduate and graduate students (N=2,782) at one university. A five-item scale was used to assess perceived public stigma toward mental health service use. Perceived need for help in the past 12 months and current presence of depressive and anxiety disorders were also assessed. Perceived stigma was higher among males, older students, Asian and Pacific Islanders, international students, students with lower socioeconomic status backgrounds, and students with current mental health problems. Perceived stigma was also higher among those without any family members or friends who had used mental health services and among those who believed that therapy or medication is not very helpful. Perceived stigma was negatively associated with the likelihood of perceiving a need for mental health services, but only among younger students. Among those with probable depressive or anxiety disorders, there was no evidence that perceived stigma was associated with service use. These results suggest that, at least in this population, perceived stigma may not be as important a barrier to mental health care as the mental health policy discourse currently assumes.

Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population-based sample of older adults using the 2005 California Health Interview Survey. The sample comprised 16,974 people aged 55 and older, with 13,974 non-Hispanic whites, 719 African Americans, 1,215 Asians, and 1,066 Latinos. Respondents were compared in terms of prevalence of symptoms of mental distress and serious mental illness, reported need for help, and access to mental health services. African Americans, Asians, and Latinos were more likely to have mental distress than whites (21.2-24.2% vs 14.4%, P<.001) and a higher prevalence of serious mental illness (4.1-7.7% vs 2.5%, P<.001). After adjustment for age, sex, birthplace, marital status, education, limited English proficiency, chronic health conditions, and insurance status, older African-American (adjusted odds ratio (aOR)=1.37, 95% confidence interval (CI)=1.04-1.81) and Asian (aOR=1.50, CI=1.13-2.00) adults still had greater odds of mental distress than whites. Furthermore, all three groups had worse access to mental health services than whites (African American aOR=0.64, 95% CI=0.43-0.96; Asian aOR=0.32, CI=0.16-0.63; Latino aOR=0.35, CI=0.17-0.70). Clinicians caring for older individuals should be aware of their high risk for mental health needs. Given that minorities' access to mental health services is worse than whites', even after adjusting for health insurance status, providing insurance alone will not eliminate this disparity. Innovative clinical and systemic strategies are needed to better identify individuals at risk and to provide needed services.

&lt;p&gt;&lt;strong&gt;Purpose:&lt;/strong&gt; To evaluate the association between mental health services (MHS) use and depressive symptom scores among gay and bisexual men (GBM) and compare with heterosexual men in Canada.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; We used data from the 2015-2016 cycles of the Canadian Community Health Survey. Depressive symptoms were assessed using the PHQ-9 questionnaire (prior two weeks). MHS consultations with any licensed mental health professional (prior year) were categorized as 0, 1, 2-11, ≥ 12. We fit linear regression models to quantify the associations between MHS use and PHQ-9 scores, with an interaction term for sexual identity (GBM and heterosexual men). Models were adjusted for socioeconomic and health-related indicators.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among 21,383 men, 97.3% self-identified as heterosexual and 2.7% as GBM. Compared to heterosexual men, GBM used any MHS (21% vs. 10%, p &lt; 0.05) and consulted ≥ 2 health professionals for their mental health (6% vs. 2%, p &lt; 0.05) in the preceding year more frequently. Overall, mean PHQ-9 scores were higher among GBM compared to heterosexual men (3.9 vs. 2.3, p &lt; 0.05). Relative to no consultations, higher MHS use (2-11, ≥ 12 consultations) was associated with higher PHQ-9 scores (1.4-4.9 points higher). Associations between MHS use and PHQ-9 scores did not differ statistically between GBM and heterosexual men.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; Our findings were inconclusive in demonstrating a difference between heterosexual men and GBM for the association between MHS use and PHQ-9 scores. However, GBM consistently had higher average PHQ-9 scores for every category of consultations. Considering the higher use of MHS and higher burden of depressive symptoms among GBM, more research is needed.&lt;/p&gt;

Unmet Mental Health Need and Access to Services for Children With Special Health Care Needs and Their Families

Previous research has shown that difficulties in intimate relationships promote mental health treatment seeking for male veterans, but findings for female veterans have been mixed. The current study sought to further evaluate whether intimate relationship functioning is a motivator for mental health treatment seeking for male and female veterans and examine the impact of different types of trauma exposure on this association. Using data from a longitudinal study, we examined whether intimate relationship functioning mediated the association between posttraumatic stress disorder (PTSD) symptom severity and mental health service use (0 = no mental health services, 1 = any mental health services) in male and female veterans (N = 1,200). We used multiple groups path analysis to examine whether intimate relationship functioning mediated the association between PTSD symptom severity and mental health service use for male and female veterans. For male veterans, greater PTSD symptom severity was related to poorer intimate relationship functioning, which in turn explained increased likelihood of mental health service use (R² = .18). This mediation effect was not significant for female veterans. Our findings suggest that targeting intimate relationship functioning in treatment for male veterans may be beneficial because difficulties in these relationships appear to be a motivating factor for treatment seeking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).