Seeking treatment for mental health problems has become more acceptable
since the early 1990s, according to a new study. The more positive attitudes
toward treatment over time may have contributed to a growing demand for mental
health services over recent years.
Data comparing attitudes toward mental health treatment in two nationally
representative surveys showed that 27.1 percent of those surveyed between 1990
and 1992 reported being "very comfortable" with talking to a
professional about personal problems, compared with 32.4 percent of those
surveyed between 2001 and 2003.
The findings appeared in the May Psychiatric Services.
Lead author Ramin Mojtabai, M.D., Ph.D., told Psychiatric News
that although he couldn't draw any definitive conclusions about these
findings, he believed that a number of changes in the mental health field may
have shifted attitudes for the better. Mojtabai is a PGY-3 resident in
psychiatry at Beth Israel Medical Center in New York.
Throughout the 1990s there was an increase in direct-to-consumer marketing
of antidepressants, he explained, and a surge in depression-prevention and
suicide-screening programs. This may have had a positive effect on public
attitudes toward treatment.
To detect these trends in attitudes about mental illness, Mojtabai compared
data from respondents to the 1990-1992 National Comorbidity Study (NCS) with
those from the 2001-2003 NCS—Replication (NCS-R), both of which studied
mental health problems and treatment in the United States.
For the NCS, researchers interviewed 8,098 randomly selected people aged 15
to 54 in their homes. For the NCS-R 10 years later, they interviewed a
separate, randomly selected sample of 9,282 adults over age 18 in their
Three questions generated responses on attitudes toward mental health
treatment: Participants reported whether they would seek help for a serious
emotional problem on a scale ranging from "probably" to"
definitely not," the degree to which they were comfortable
talking about personal problems to a professional, and the degree to which
they would be embarrassed if their friends knew they were getting professional
help for an emotional problem (see chart). Responses to these questions were
categorized on a scale from 0 to 3, with higher scores indicating more
positive attitudes toward treatment.
Mojtabai found that 35.6 percent of respondents to the NCS reported that
they would "definitely" go for professional help for a serious
emotional problem, compared with 41.4 percent of NCS-R respondents. He also
found that 33.7 percent of NCS respondents reported that they would not be
embarrassed if friends knew about their getting professional help. This number
jumped to 40.3 percent for respondents to the later survey.
When Mojtabai analyzed the findings by age, he found that adults aged 18 to
34 in the NCS-R had more positive attitudes toward mental health treatment
seeking than adults of the same age did in the original NCS. However, adults
in the 35 to 54 age range showed little change in attitudes at the two time
"Although attitudes toward mental health treatment seeking improved
in all generations," he said, "the improvement was greatest in the
generation that was 15 to 24 years old in 1990 to 1992." This may be
because they had more exposure to public-information campaigns and other
positive media messages about mental illness, Mojtabai speculated.
Data based on logistical regression analyses of treatment-seeking attitudes
showed that black participants were 56 percent more likely to have a positive
attitude toward treatment than were whites.
In addition, respondents with a history of mental health treatment were 68
times as likely to have a favorable attitude toward mental health treatment as
those who didn't.
Mojtabai said future research should explore what specific factors impact
attitude toward mental health treatment. "We also need to examine the
impact of attitudes on service use," he noted.
An abstract of "Americans' Attitudes Toward Mental Health
Treatment Seeking: 1990-2003" is posted at<http://ps.psychiatryonline.org/cgi/content/full/58/5/642>.▪