This study examined whether people who self-reported depression sought mental health treatment in the year after being interviewed, and how gender affected utilization. Depression data were obtained from the Canadian Community Health Survey (2000-01), and linked to medical records in Ontario (n = 24,677). Overall, women had higher rates of mental health service utilization, but there were no gender differences in rates of specialist care. The gender difference in mental health contact was greater for those without depression, as opposed to those with depression. Among those without depression, women were significantly more likely than men to use mental health services; however, rates were similar for women and men with depression. This finding suggests that men may be more likely than women to delay seeing a doctor for minor mental health concerns, but will seek help once a problem reaches a threshold.
KeywordsDepressionGenderMental Health Service UtilizationSurveyMedical Records
Hasin, D.S., Goodwin, R.D., Stinson, F.S. and Grant, B.F. (2005) Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on alcoholism and related conditions. Archives of General Psychiatry, 62, 1097-1106. http://dx.doi.org/10.1001/archpsyc.62.10.1097
Smith, K.L.W., Matheson, F.I., Moineddin, R. and Glazier, R.H. (2007) Gender, income and immigration differences in depression in Canadian urban centres. Canadian Journal of Public Health, 98, 149-153.
Sareen, J., Cox, B.J., Afifi, T.O., Yu, B.N. and Stein, M.B. (2005) Mental health service use in a nationally representative Canadian survey. Canadian Journal of Psychiatry, 50, 753-761.
Ontario Ministry of Health and Long Term Care (2011) Mental health: Depression. Ontario Ministry of Health and Long Term Care, Toronto. http://www.health.gov.on.ca/english/public/pub/mental/depression.html
WHO (2013) Suicide rates per 100,000 by country, year and sex (Table). http://www.who.int/mental_health/prevention/suicide_rates/en/
Satyanarayana, S., Enns, M.W., Cox, B.J. and Sareen, J. (2009) Prevalance and correlates of chronic depression in the Canadian Community Health Survey: Mental health and well-being. Canadian Journal of Psychiatry, 54, 389-398.
Kessler, R.C., Frank, R.G., Edlund, M. and Katz, S.J. (1997) Differences in the use of psychiatric outpatient services between the United States and Ontario. New England Journal of Medicine, 336, 551-557. http://dx.doi.org/10.1056/NEJM199702203360806
Katz, S.J., Kessler, R.C., Frank, R.G., Leaf, P., Lin, E. and Edlund, M. (1997) The use of outpatient mental health services in the United States and Ontario: The impact of mental morbidity and perceived need for care. American Journal of Public Health, 87, 1136-1143. http://dx.doi.org/10.2105/AJPH.87.7.1136
Wang, J.L., Patten, S.B., Williams, J.V.A., Currie, S., Beck, C.A., Maxwell, C.J. and El-Guebaly, N. (2005) Help-seeking behaviours of individuals with mood disorders. Canadian Journal of Psychiatry, 50, 652-659.
Wang, P.S., Berglund, P. and Kessler, R.C. (2000) Recent care of common mental disorders in the United States: Prevalence and conformance with evidence-based recommendations. Journal of General Internal Medicine, 15, 284-292. http://dx.doi.org/10.1046/j.1525-1497.2000.9908044.x
Wang, P.S., Lane, M., Olfson, M., Pincus, H.A., Wells, K.B. and Kessler, R.C. (2005) Twelve-month use of mental health services in the United States: Results from the national comorbidity survey replication. Archives of General Psychiatry, 62, 629-640. http://dx.doi.org/10.1001/archpsyc.62.6.629
Alonso, J., Angermeyer, M.C., Bernert, S., Bruffaerts, R., Brugha, T.S., Bryson, H., et al. (2004) Use of mental health services in Europe: Results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109, 47-54. http://dx.doi.org/10.1111/j.1600-0047.2004.00325.x
Leaf, P.J. and Bruce, M.L. (1987) Gender differences in the use of mental health-related services: A re-examination. Journal of Health and Social Behavior, 28, 171-183. http://dx.doi.org/10.2307/2137130
Rhodes, A., Jaakkimainen, R.L., Bondy, S. and Fung, K. (2006) Depression and mental health visits to physicians —A prospective records-based study. Social Science & Medicine, 62, 828-834. http://dx.doi.org/10.1016/j.socscimed.2005.06.039
Rhodes, A. and Goering, P. (1994) Gender differences in the use of outpatient mental health services. Journal of Mental Health Administration, 21, 338-346. http://dx.doi.org/10.1007/BF02521353
Chatterjee, S., Rath, M.E., Spiro, A., Eisen, S., Sloan, K.L. and Rosen, A.K. (2009) Gender differences in veterans health administration mental health service use: Effects of age and psychiatric diagnosis. Women’s Health Issues, 19, 176-184. http://dx.doi.org/10.1016/j.whi.2009.03.002.
Shapiro, S., Skinner, E.A., Kessler, L.G., VonKorff, M., German, P.S., Tischler, G.L., Leaf, P.J., Benham, L., Cottler, L. and Regier, D.A. (1984) Utilization of health and mental health services. Archives of General Psychiatry, 41, 971-978. http://dx.doi.org/10.1001/archpsyc.1984.01790210053007
Drapeau, A., Boyer, R. and Lesage, A. (2009) The influence of social anchorage on the gender difference in the use of mental health services. Journal of Behavioral Health Services & Research, 36, 372-384. http://dx.doi.org/10.1007/s11414-009-9168-0
Galdas, P.M., Cheater, F. and Marshall, P. (2005) Men and health help-seeking behaviour: Literature review. Journal of Advanced Nursing, 49, 616-623. http://dx.doi.org/10.1111/j.1365-2648.2004.03331.x
Green, C.A. and Pope, C.R. (1999) Gender, psychosocial factors and the use of medical services: A longitudinal analysis. Social Science & Medicine, 48, 1363-1372. http://dx.doi.org/10.1016/S0277-9536(98)00440-7
Rhodes, A.E. and Fung, K. (2004) Self-reported use of mental health services versus administrative records: Care to recall? International Journal of Methods in Psychiatric Research, 13, 165-175. http://dx.doi.org/10.1002/mpr.172
Rhodes, A.E., Lin, E. and Mustard, C.A. (2002) Self-reported use of mental health services versus administrative records: Should we care? International Journal of Methods in Psychiatric Research, 11, 125-133. http://dx.doi.org/10.1002/mpr.130
Palin, J.L., Goldner, E.M., Koehoorn, M. and Hertzman, C. (2011) Primary mental health care visits in self-reported data versus provincial administrative records. Health Reports, 22, 41-47.
Drapeau, A., Boyer, R. and Diallo, F.B. (2011) Discrepancies between survey and administrative data on the use of mental health services in the general population: Findings from a study conducted in Quebec. BMC Public Health, 11, 837. http://dx.doi.org/10.1186/1471-2458-11-837
Beland, Y. (2002) Canadian community health survey— Methodological overview. Health Reports, 13, 9-14.
Steele, L.S., Glazier, R.H., Lin, E. and Evans, M. (2004) Using administrative data to measure ambulatory mental health service provision in primary care. Medical Care, 42, 960-965. http://dx.doi.org/10.1097/00005650-200410000-00004
Ontario Ministry of Health and Long Term Care (2011) Schedule of benefits for physician services under the Health Insurance Act. Ontario Ministry of Health and Long Term Care, Toronto. http://www.health.gov.on.ca/english/providers/program/ohip/sob/physserv/physserv_mn.html
Kessler, R.C., Andrews, G., Mroczek, D., Ustun, B. and Wittchen, H.U. (1998) The World Health Organization composite international diagnostic interview short-form (CIDI-SF). International Journal of Methods in Psychiatric Research, 7, 171-185. http://dx.doi.org/10.1002/mpr.47
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington DC.
Matheson, F.I., LaFreniere, M.C., White, H.L., Moineddin, R., Dunn, J.R. and Glazier, R.H. (2011) Influence of neighborhood deprivation, gender and ethno-racial origin on smoking behavior of Canadian youth. Preventive Medicine, 52, 376-380. http://dx.doi.org/10.1016/j.ypmed.2011.02.011
Matheson, F.I., White, H.L., Moineddin, R., Dunn, J.R. and Glazier, R.H. (2012) Drinking in context: The influence of gender and neighbourhood deprivation on alcohol consumption. Journal of Epidemiology and Community Health, 66, e4. http://dx.doi.org/10.1136/jech.2010.112441
Matheson, F.I., Moineddin, R., Dunn, J.R., Creatore, M.I., Gozdyra, P. and Glazier, R.H. (2006) Urban neighborhoods, chronic stress, gender and depression. Social Science and Medicine, 63, 2604-2616. http://dx.doi.org/10.1016/j.socscimed.2006.07.001
White, H.L., Matheson, F.I., Moineddin, R., Dunn, J.R. and Glazier, R.H. (2011) Neighbourhood deprivation and regional inequalities in self-reported health among Canadians: Are we equally at risk? Health & Place, 17, 361-369. http://dx.doi.org/10.1016/j.healthplace.2010.11.016
Last, J.M. (1995) A dictionary of epidemiology. Oxford University Press, New York.
Statistics Canada (2011) The research data centres program. Data Sets—Bootvar. Statistics Canada, Ottawa. http://www.statcan.gc.ca/rdc-cdr/data-donnee-eng.htm
Ontario Ministry of Health and Long Term Care (2011) Ontario health insurance (OHIP)-Ministry programs. Ontario Ministry of Health and Long Term Care, Toronto. http://health.gov.on.ca/en/public/programs/ohip/
Hosmer, D.W. and Lemeshow, S. (2000) Applied logistic regression. 2nd Edition. Wiley, New York. http://dx.doi.org/10.1002/0471722146
Wang, P.S., Berglund, P.A. and Kessler, R.C. (2003) Patterns and correlates of contacting clergy for mental disorders in the United States. Health Services Research, 38, 647-673. http://dx.doi.org/10.1111/1475-6773.00138
Chatters, L.M., Mattis, J.S., Woodward, A.T., Taylor, R.J., Neighbors, H.W. and Grayman, N.A. (2011) Use of ministers for a serious personal problem among African Americans: Findings from the national survey of American life. American Journal of Orthopsychiatry, 81, 118-127. http://dx.doi.org/10.1111/j.1939-0025.2010.01079.x
Ablon, J. (2002) The nature of stigma and medical conditions. Epilepsy & Behavior, 3, 2-9. http://dx.doi.org/10.1016/S1525-5050(02)00543-7
Corrigan, P.W., Morris, S.B., Michaels, P.J., Rafacz, J.D. and Rusch, N. (2012) Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63, 963-973. http://dx.doi.org/10.1176/appi.ps.201100529
Kessler, R.C., Brown, R.L. and Broman, C.L. (1981) Sex differences in psychiatric help-seeking: Evidence from four large-scale surveys. Journal of Health and Social Behavior, 22, 49-64. http://dx.doi.org/10.2307/2136367
Shapiro, S., Skinner, E.A., Kessler, L.G., Von Korff, M., German, P.S., Tischler, G.L., Leaf, P.J., Benham, L., Cottler, L. and Regier, D.A. (1984) Utilization of health and mental health services. Three epidemiologic catchment area sites. Archives of General Psychiatry, 41, 971-978. http://dx.doi.org/10.1001/archpsyc.1984.01790210053007
Neighbors, H.W., Caldwell, C., Williams, D.R., Nesse, R., Taylor, R.J., Bullard, K.M., Torres, M. and Jackson, J.S. (2007) Race, ethnicity, and the use of services for mental disorders: Results from the National Survey of American Life. Archives of General Psychiatry, 64, 485-494. http://dx.doi.org/10.1001/archpsyc.64.4.485
Kastrup, M. (1987) Sex differences in the utilization of mental health services: A nation-wide register study. International Journal of Social Psychiatry, 33, 171-184. http://dx.doi.org/10.1177/002076408703300301
Le, M.O., Zane, N., Cho, Y.I. and Takeuchi, D.T. (2009) Use of specialty mental health services by Asian Americans with psychiatric disorders. Journal of Consulting and Clinical Psychology, 77, 1000-1005. http://dx.doi.org/10.1037/a0017065
Seedat, S., Stein, D.J., Herman, A., Kessler, R., Sonnega, J., Heeringa, S., Williams, S. and Williams, D. (2008) Twelve-month treatment of psychiatric disorders in the South African Stress and Health Study (World Mental Health Survey Initiative). Social Psychiatry and Psychiatric Epidemiology, 43, 889-897. http://dx.doi.org/10.1007/s00127-008-0399-9
Roberge, P., Fournier, L., Duhoux, A., Nguyen, C.T. and Smolders, M. (2011) Mental health service use and treatment adequacy for anxiety disorders in Canada. Social Psychiatry and Psychiatric Epidemiology, 46, 321-330. http://dx.doi.org/10.1007/s00127-010-0186-2
Wang, P.S., Demler, O., Olfson, M., Pincus, H.A., Wells, K.B. and Kessler, R.C. (2006) Changing profiles of service sectors used for mental health care in the United States. The American Journal of Psychiatry, 163, 1187-1198. http://dx.doi.org/10.1176/appi.ajp.163.7.1187
Salkow, K. and Fichter, M. (2003) Homelessness and mental illness. Current Opinion in Psychiatry, 16, 467-471. http://dx.doi.org/10.1097/01.yco.0000079207.36371.29
Hwang, S.W. (2001) Mental illness and mortality among homeless people. Acta Psychiatrica Scandinavica, 103, 81. http://dx.doi.org/10.1034/j.1600-0447.2001.103002081.x
Lin, E., Goering, P., Offord, D.R. and Campbell, D. (1996) The use of mental health services in Ontario: Epidemiologic findings. Canadian Journal of Psychiatry, 41, 572-577.