Barriers to treatment seeking for anxiety disorders: initial data on the role of mental health literacy

Depress Anxiety. 2010;27(1):63-71. doi: 10.1002/da.20620.


Background: Anxiety disorders represent the single largest mental health problem in the United States [Greenberg et al., 1999. J Clin Psychiatry 60:427-435; Rice and Miller, 1998. Br J Psychiatry 173:4-9]. However most individuals with anxiety disorders never seek treatment [Henderson et al., 2002. Can J Psychiatry 47:819-824; Mojtabai et al., 2002. Arch Gen Psychiatry 59:77-84; Roness et al., 2005. Acta Psychiatr Scand 111:51-58]. Deficits in the ability to recognize anxiety disorders and beliefs about them, (i.e., "mental health literacy") may contribute to low levels of help seeking.

Methods: Survey data assessing mental health literacy for multiple anxiety disorders and for depression were collected from 284 undergraduate students enrolled in psychology courses at a public university in the United States. Specifically, respondents were presented with vignettes portraying individuals experiencing various forms of mental illness and were asked to label the disorder, its cause and whether or not they would recommend treatment.

Results: Findings showed that social phobia and obsessive compulsive disorder (OCD) were associated with recognition rates that were generally high and similar to depression (approximately 80%). In contrast, less than half of the respondents labeled panic disorder or generalized anxiety disorder (GAD) correctly. Symptoms of OCD were attributed to mental illness by approximately 50% of respondents, but such attributions were rare for the other anxiety disorders studied (<12%). Finally, data on help-seeking recommendations suggested that such recommendations are far from universal and varied between different anxiety disorders and according to perceptions of the causes of symptoms.

Conclusions: Given that the current sample was well-educated young adults, mental health literacy of the general public may be even lower.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology*
  • Anxiety Disorders / therapy*
  • Attitude to Health
  • Awareness*
  • Diagnosis, Differential
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Literacy*
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / psychology
  • Obsessive-Compulsive Disorder / therapy
  • Panic Disorder / diagnosis
  • Panic Disorder / psychology
  • Panic Disorder / therapy
  • Patient Acceptance of Health Care / psychology*
  • Phobic Disorders / diagnosis
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy
  • Students / psychology
  • United States
  • Young Adult