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. 2017 Aug;52(8):1005-1013.
doi: 10.1007/s00127-017-1384-y. Epub 2017 Apr 29.

Trends in non-help-seeking for mental disorders in Germany between 1997-1999 and 2009-2012: a repeated cross-sectional study

Susanne Brandstetter  1 , Frank Dodoo-Schittko  2 , Sven Speerforck  3 , Christian Apfelbacher  2 , Hans-Jörgen Grabe  3 , Frank Jacobi  4 , Ulfert Hapke  5 , Georg Schomerus  3 , Sebastian E Baumeister  6   7
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Trends in non-help-seeking for mental disorders in Germany between 1997-1999 and 2009-2012: a repeated cross-sectional study

Susanne Brandstetter et al. Soc Psychiatry Psychiatr Epidemiol. 2017 Aug.

Abstract

Purpose: This study sought to examine trends in non-help-seeking for mental disorders among persons with a prevalent mental disorder (12-month prevalence) in Germany between 1997-1999 and 2009-2012.

Methods: We examined data from 1909 persons aged 18-65 years who participated in two independent, repeated cross-sectional surveys (German National Interview and Examination Study 1997-1999, German Health Interview and Examination Survey for Adults 2009-2012) conducted 12 years apart. Prevalent mental disorders (12-month prevalence) were determined using the Composite International Diagnostic Interview, which included information on lifetime help-seeking for mental health problems. Correlates of self-reported help-seeking were analyzed according to Andersen's Behavioral Model. Multivariable Poisson regression models were used to assess time trends in the directly standardized and model-adjusted prevalence of non-help-seeking across strata of socio-economic and clinical variables.

Results: The proportion of people with a prevalent mental disorder who have never sought help in their lifetime decreased significantly from 62% (95% CI 58.7-64.7) to 57% (95% CI 52.2-60.9) between 1997-1999 and 2009-2012 in adults aged 18-65 years in Germany. Downward trends in non-help-seeking occurred in all investigated strata and reached statistical significance in women, in people who were living alone, people with medium educational level, people living in middle-sized communities, people with non-statutory health insurance, smokers, and people with co-existing somatic conditions.

Conclusion: Despite a downward trend over the course of 12 years, a large proportion of people suffering from mental disorders are still not seeking treatment in Germany. Further efforts to increase uptake of help-seeking for mental disorders in hard-to-reach groups are warranted to continue this trend.

Keywords: Help-seeking; Mental disorders; Mental health; Trends.

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