Mental health services use among adults with or without mental disorders: Do development stages matter?

Int J Soc Psychiatry. 2016 Aug;62(5):434-51. doi: 10.1177/0020764016641906. Epub 2016 Apr 13.


Background: Mental health services (MHS) use is a complex behaviour that does not only concern individuals with current mental disorder. To date, few studies have examined age-related contextualisation of MHS use. Reasons for seeking help may vary according to development stages in adulthood.

Aims: This study aimed to determine which predisposing, enabling and need factors, using Andersen's model, were associated with MHS use according to adult development stages among individuals with or without current psychiatric diagnosis.

Methods: Three age groups were examined: 18- to 29-year-olds (n = 775), 30- to 49-year-olds (n = 1,560) and 50- to 64-year-olds (n = 960). Data were obtained from the Montreal Longitudinal Catchment Area Study. Bivariate and multivariate logistic regression analyses were conducted for each age group separately to determine which predisposing, enabling and need factors were associated with MHS use in the past 12 months.

Results: For 18- to 29-year-olds, one enabling factor (Internet search) and two need factors (presence of major depressive disorder and number of stressful events) were positively associated with MHS use. For 30- to 49-year-olds, one predisposing factor (family history of mental disorder), four enabling factors (not currently working or in school, perceiving neighbourhood disorder, social cohesion and Internet searching) and one need factor (major depressive disorder) correlated with help seeking. For 50- to 64-year-olds, two predisposing factors (family history of mental disorder and higher self-perceived stigma), two enabling factors (low satisfaction in personal relationship and Internet searching) and one need factor (alcohol dependence) were associated with MHS use.

Conclusions: Factors associated with MHS use differ according to adult development stages. Programmes and policies should be based on age-related contextualisation to increase MHS use.

Keywords: Andersen’s model; Service utilisation; development; emerging adulthood; mental health; middle adulthood.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Female
  • Help-Seeking Behavior*
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy
  • Mental Health
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Multivariate Analysis
  • Quebec
  • Sex Distribution
  • Young Adult