Who experiences unmet need for mental health services and what other barriers to accessing health care do they face? Findings from Australia and Canada

Abstract

Purpose: To examine factors associated with unmet need for mental health services and links with barriers to access to care more broadly.

Methodology: The Commonwealth Fund International Health Policy Surveys from 2013 and 2016 were used to explore factors associated with unmet need for adults who experienced emotional distress for 1320 respondents in Australia and 2284 in Canada.

Findings: Over one in five adults in Australia (21%) and in Canada (25%) experienced emotional distress, just over half said they received professional help (51% in Australia, 59% in Canada). The majority of those who did not get help indicated did not want to see a professional (37% in Australia, 30% in Canada). For those who did seek help, the factors associated with not receiving care included lower income, higher out-of-pocket health care costs, and poorer health. When compared with people with met needs, those with unmet needs for mental health services were more likely to also experience affordability, medication, and trust-related access barriers (AOR range 2.41 to 7.49 for the two countries, P < 0.01).

Conclusion: Including unmet needs for mental health services as part of regular reporting on access to care may bring attention to access barriers for people with mental health conditions.

Keywords: accessibility of health care services; health care disparities; mental health; unmet need.