Barriers to the treatment of social anxiety

Am J Psychiatry. 2000 Apr;157(4):521-7. doi: 10.1176/appi.ajp.157.4.521.


Objective: This article evaluates barriers to treatment reported by adults with social anxiety who participated in the 1996 National Anxiety Disorders Screening Day.

Method: The background characteristics of screening day participants with symptoms of social anxiety (N=6,130) were compared with those of participants without social anxiety (N=4,507). Barriers to previous mental health treatment reported by participants with and without symptoms of social anxiety were compared.

Results: Social anxiety was strongly associated with functional impairment, feelings of social isolation, and suicidal ideation. Compared to participants without social anxiety, those with social anxiety were significantly more likely to report that financial barriers, uncertainty over where to go for help, and fear of what others might think or say prevented them from seeking treatment. However, they were significantly less likely to report they avoided treatment because they did not believe they had an anxiety disorder. Roughly one-third (N=1,400 of 3,682, 38.0%) of the participants with symptoms of social anxiety who were referred for further evaluation were specifically referred for an evaluation for social phobia.

Conclusions: Social anxiety is associated with a distinct pattern of treatment barriers. Treatment access may be improved by building public awareness of locally available services, easing the psychological and financial burden of entering treatment, and increasing health care professionals' awareness of its clinical significance.

MeSH terms

  • Adult
  • Attitude to Health*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Female
  • Health Care Costs
  • Health Education
  • Health Surveys
  • Humans
  • Insurance, Psychiatric
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Acceptance of Health Care
  • Phobic Disorders / diagnosis*
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy*
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Referral and Consultation
  • Social Support
  • Suicide / psychology
  • United States
  • Videotape Recording