TY - JOUR
T1 - Investigating unrecognized needs and structural barriers to treatment of depressive symptoms
T2 - a nationwide cross-sectional study in Portugal
AU - Roxo, Luis
AU - Perelman, Julian
N1 - Funding Information:
This work was supported by a Doctoral fellowship provided by the Portuguese Foundation for Science and Technology – FCT [ PD/BD/135591/2018 ] to the first author. The institution did not intervene in the study design; analysis and interpretation of data; writing of the manuscript; or the decision to submit it for publication.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/7
Y1 - 2022/7
N2 - This study assesses factors associated with perception of need and affordability concerns regarding mental health services (MHS), among 978 persons with meaningful depressive symptoms (Patient Health Questionnaire≥10). We used data from the 6th Portuguese National Health Interview Survey and used logistic regressions with gender, age, severity of symptoms, education, and income as explanatory variables. Health insurance was added as mediation variable. Unrecognized need (59.3% of the sample) was more likely amongst men, those over 65, high-educated, and those with moderate symptoms, compared to women, aged 18–34, low-educated, and those with severe symptoms. Among those reporting they needed MHS, 44.6% were not able to pay for them. Affordability concerns were more likely amongst men, those under 50, severely depressed, high-educated, and less likely amongst those within the highest income quintile. Adjusting for health insurance did not change the results in a meaningful way. Unrecognized need and affordability concerns are common among depressed persons in Portugal but seem unevenly distributed across social groups. Investing in the capacity of primary healthcare services to treat depression may be crucial to promote perception of need and reduce structural barriers.
AB - This study assesses factors associated with perception of need and affordability concerns regarding mental health services (MHS), among 978 persons with meaningful depressive symptoms (Patient Health Questionnaire≥10). We used data from the 6th Portuguese National Health Interview Survey and used logistic regressions with gender, age, severity of symptoms, education, and income as explanatory variables. Health insurance was added as mediation variable. Unrecognized need (59.3% of the sample) was more likely amongst men, those over 65, high-educated, and those with moderate symptoms, compared to women, aged 18–34, low-educated, and those with severe symptoms. Among those reporting they needed MHS, 44.6% were not able to pay for them. Affordability concerns were more likely amongst men, those under 50, severely depressed, high-educated, and less likely amongst those within the highest income quintile. Adjusting for health insurance did not change the results in a meaningful way. Unrecognized need and affordability concerns are common among depressed persons in Portugal but seem unevenly distributed across social groups. Investing in the capacity of primary healthcare services to treat depression may be crucial to promote perception of need and reduce structural barriers.
KW - Depression
KW - Gender
KW - Mental health services
KW - Portugal
KW - Socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=85130839115&partnerID=8YFLogxK
U2 - 10.1016/j.psychres.2022.114623
DO - 10.1016/j.psychres.2022.114623
M3 - Article
C2 - 35597138
AN - SCOPUS:85130839115
SN - 0165-1781
VL - 313
JO - Psychiatry Research
JF - Psychiatry Research
M1 - 114623
ER -