CG123 Common mental health disorders - National Institute for ...

Access to healthcareIndividual-level factorsGeneral populationIndividual attributes and beliefs may have an important impact on access to healthcareservices, specifically mental healthcare services. Previous research has identifiedstigma, shame and fear of being diagnosed with a mental health disorder as possiblefactors affecting access to healthcare (COCHRANE2007, DAS2006, DENNIS2006,DIXONWOODS2005, PRINS2008, RODRIGUEZ2009, SCHEPPERS2006,VANVOORHES2007). Disparities in power have also been identified (DIXON-WOODS2005), with some individuals not seeking treatment to avoid feeling disempoweredbecause they may view seeking help as the relinquishing of power andresignation of the self to one’s symptoms. People have also been found to normalisesymptoms of mental health disorders and view mental health disorders not as an illnessbut as a sign of weakness (DENNIS2006) or as not worthy of investigation (DIXON-WOODS2005). In the review by DENNIS2006, women from a variety of cultural andethnic backgrounds viewed depression in the postnatal period as an inability toperform as a woman and a mother, and as an implied weakness or perceived failure.RODRIGUEZ2009 suggested that the word ‘clinic’, especially in reference to mentalhealth services, can be frightening to individuals and can deter them from obtainingnecessary help. Self-medicating (with illicit drugs and alcohol) and coexisting physicalhealth problems may also mask depression and anxiety disorders (DAS2006).Lack of knowledge about mental health disorders, services and availabletreatment options have also been identified as factors that affect access to treatment.Some individuals may not be aware they have symptoms of a mental health disorder(DENNIS2006, DIXONWOODS2005, PRINS2008, SCHEPPERS2006,VANVOORHES2007, COCHRANE2007). For mental healthcare services in particular,individual perceptions as to how much a service can help may also influence aperson’s decision to access healthcare services (DIXONWOODS2005). A fear ofchild protection becoming involved, and the concern that children will be taken awayfollowing diagnosis of a mental health disorder, may discourage individuals fromaccessing healthcare services (RODRIGUEZ2009, SCHEPPERS2006).Black and minority ethnic groupsThe combination of being from a BME group as well as having a mental health diagnosismay result in additional feelings of stigma (VANVOORHES2007).Furthermore, there is evidence to suggest that certain BME groups find treatment formental health disorders (both medication and psychological therapies) less acceptablethan other ethnic groups (DAS2006, VANVOORHES2007). In some BME groupsthere may also be a belief that health professionals are an inappropriate source ofsupport and help for mental health disorders (COCHRANE2007, DENNIS2006,SCHEPPERS2006). BME groups may also believe in self-reliance for mental healthproblems (RODRIGUEZ2009, SCHEPPERS2006). All of this may contribute to individualsbeing unwilling to access healthcare services to discuss symptoms or treatmentoptions, and preferring alternative sources of support. For example, BMEgroups may see religion as a way of coping with mental health disorders(RODRIGUEZ2009, SCHEPPERS2006, VANVOORHES2007).64