“I don’t need any treatment” – barriers to mental health treatment in the general population of a megacity

Objective: Most countries fail to treat individuals with psychopathologies. Investigating treatment barriers and reasons for dropout are key elements to overcoming this scenario. Methods: A representative sample of 2,942 urban-dwelling adults was interviewed face-to-face within a cross-sectional, stratified, multistage probability survey of the general population. Psychiatric diagnosis, severity level, use of services, reasons for not seeking treatment, and treatment dropout were investigated. Results: Only 23% of individuals with a psychopathology of any severity level in the last 12 months received treatment. Low perceived need for treatment (56%) was the most common reason for not seeking treatment. The most visited settings were psychiatric, other mental health care, and general medical care. Among those with a perceived need for treatment (44%), psychological barriers were the most common reason for not seeking it. Treatment dropout was more prevalent among those who visited a general medical care setting. Among individuals still in treatment, human services and psychiatric care were the most common types. Female sex was associated with structural barriers (OR = 2.1). Disorder severity was negatively associated with need barriers (OR = 0.4), and positively associated with structural barriers (OR = 2.5) and psychological barriers (OR = 2.5). Conclusion: Despite the need for treatment and better services, psychological barriers were the major reason for not seeking treatment. Apart from providing more specialists, investing in awareness, de-stigmatization, and information is the ultimate strategy for improving psychiatric care.

Bibliographic Details

Main Authors:	Coêlho,Bruno M., Santana,Geilson L., Viana,Maria C., Wang,Yuan-Pang, Andrade,Laura H.
Format:	Digital revista
Language:	English
Published:	Associação Brasileira de Psiquiatria 2021
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462021000600590
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