Psychological barriers included stigmatization of depression, doubts that treatment is effective, or concerns that others may find out ( 14, 16, 17, 19 – 21 ), and these barriers were particularly prevalent among women and people of color ( 5, 16, 17, 19, 20 ).
Full Answer
What are the barriers to accepting a depression diagnosis?
“Denial” For a person not to recognize and accept a depression diagnosis “Putting on a Front” Pretending nothing is wrong to others / covering up or wearing a mask External Barriers “Spiritual Beliefs” Beliefs about depression and how it relates to religious beliefs and faith “Lack of Resources”
What are the barriers of mental health treatment?
Practical barriers include cost concerns (whether real or assumed), availability of transportation, not knowing where to go for treatment, etc. Psychological barriers include obstacles such as worries about stigmatization and doubts about the effectiveness of treatment.
How do others minimize symptoms of depression?
Others minimized symptoms by acting as if their stress was normal, and by initially rejecting the diagnosis of depression. They gave me the drugs, the Paxil and stuff like that, but ‘I don’t need that’ is what I told them and I just took myself off [medication] and I basically refused treatment from a therapist too.
Why don’t people with depression get treatment?
15 Reasons Why People With Depression Don’t Get Treatment 1 Had no transportation or treatment too far (5.8 percent). 2 Didn’t want others to find out (6.5 percent). 3 Health insurance didn’t cover it (6.5 percent). 4 Concern about effect on job (8.1 percent). 5 Didn’t think I needed it at that time (8.6 percent). 6 ... (more items)
Why don't people take the steps needed to get help for depression?
Some of the most common reasons people do not take the steps needed to obtain help for depression include: Fear and shame: People recognize the negative stigma and discrimination of being associated with a mental illness.
Why do people not seek help for depression?
Some of the most common reasons people do not take the steps needed to obtain help for depression include: 1 Fear and shame: People recognize the negative stigma and discrimination of being associated with a mental illness. Fear of being labeled weak is part of the human condition, and it is natural to worry about impact on education, careers and life goals. 2 Lack of insight: When someone has clear signs of a mental illness but is convinced nothing is wrong, this is known as anosognosia. 3 Limited awareness: A person sometimes minimizes their issues and rationalizes that what is going on is “not that bad” or “everyone gets stressed.” Learning more about symptoms and conditions is advised for everyone wanting to better understand depression. 4 Feelings of inadequacy: Many people believe that they are inadequate or it would mean failure to admit that something is wrong. They believe they should be able to handle it. 5 Distrust: Some find it difficult to share personal details with a counselor, and may worry that information will not be kept confidential 6 Hopelessness: Sometimes there is a feeling that nothing will ever get better and nothing will help. 7 Unavailability: Some may not know how to find help, and in underserved areas this problem is more significant. 8 Practical barriers: A lack of reliable transportation or the ability to pay for services or appointments times that conflict with work or school schedules are significant.
Why is the integration of primary care and mental health services important?
The continuing integration of primary care and mental health services is meant to streamline the processes involved in getting people to the help that they need.
What does it mean when you feel inadequate?
Feelings of inadequacy: Many people believe that they are inadequate or it would mean failure to admit that something is wrong. They believe they should be able to handle it.
What is the second internal barrier?
The second internal barrier was “mind-set.” These participants believed that depression was a part of life, and was something that everyone had to deal with, but that it was something that did not necessarily require professional intervention. This point of view was described as being long-term or chronic:
What are the mental health disparities in rural African Americans?
Disparities that are evident in rural communities include limited mental health resources and the stigma of depression. The faith community has a long-standing history of being the initial source of help to those who experience depression. The purpose of this qualitative study was to examine how rural African-American faith communities view the barriers to diagnosis and treatment of depression. A convenience sample of 24 persons (N = 24) participated in focus groups and interviews. Four internal barriers were identified: personal business, “mind-set,” “denial,” and “put on a front.” Additionally, four external barriers were identified: “spiritual beliefs,” “lack of medical resources,” “lack of education about depression,” and “stigma.” The identified barriers supported the results from previous studies, but they also highlighted other less acknowledged barriers. In conclusion, interventions are needed to overcome these barriers in order to eliminate the depression disparities experienced by this population.
Is depression a part of life?
Many of the participants thought that people did not recognize depression or depressive symptoms as being something abnormal or unusual. In their opinions, depression was just a part of life. Therefore, the idea that one should seek help was viewed as irrational. They also believed that other people might think that what they were experiencing was something different from depression. They thought that if a person was diagnosed with MDD, and he or she was depressed, it might not be accepted:
How do adults treat depression?
Many adults view treatment of depression through medical care systems with suspicion and favor alternative approaches, such as lifestyle interventions (Jorm et al., 2000). Adults often visit physicians for emotional problems only when lay resources are exhausted (Angermeyer, Ratschinger & Reidel-Heller, 1999). Although adolescents are aware of both medical and non-medical help agents (e.g., physicians and school counselors) and are aware of how to access them, they also prefer non-medical interventions (e.g., high school counselor) to entering treatment with a medical professional (Offer et al., 1991).
How to understand teen experiences of medical care for depression?
To understand teens’ experiences of obtaining medical care for depression, we used a modified grounded theory approach, based on the work of Strauss and Corbin (1998) . Grounded theory allows participants to present their experience in their own words and facilitates the theory development based on the variety of participants’ beliefs and behaviors. Grounded theory methodology includes the use of an emergent design, theoretical sampling, saturation, and concurrent data collection and analysis. Our methodology differed from this model to the extent that we used purposive rather than theoretical sampling. Purposive sampling involves the deliberate sampling for heterogeneity (Blankertz, 1998) on factors designated as important to the concepts being studied (e.g., gender, treatment status), whereas theoretical sampling seeks a sample that presents heterogeneity of concepts.
What were the factors that led to teens not being normal?
A number of the teens had experienced significant life stressors, such as physical or sexual abuse that contributed to their feelings of not being normal. Some teens observed that it was not just the stress they experienced, but their cognitions about the events that led to depression and feeling abnormal.
How often does depression recur?
Major depression is a chronic, common disorder among adolescents, with lifetime recurrence rates estimated at about 70%, and most (40–60%) recurring within 2 years (Birmaher et al., 1996; Lewinsohn, Clarke, Seeley, & Rohde, 1994). Additionally, almost all who experience depression as adolescents experience another episode as an adult (Aseltine, Gore, & Colten, 1996). Depression is strongly associated with increased risk of suicide, the third leading cause of death among adolescents 15–24 years old (Centers for Disease Control, 2002).
What are the consequences of depression in adolescents?
Depressed individuals often present with difficulties in school, interpersonal relationships, and occupational adjustment; increased tobacco and substance abuse; and suicide attempts (Birmaher et al., 1996; Luber et al., 2000; Pincus & Pettit, 2001). Academic failure and school absences are particularly important consequences for adolescents: these events can result in the teenager being separated from his or her peer group, rejected from the peer group, and diverted from a normal developmental trajectory. Adolescent depression currently accounts for a substantial portion of the health care costs incurred by this age group (Birmaher et al., 1996), which are expected to increase as the prevalence of depression among children and adolescents rises and incidence occurs at younger ages (Gjerde, 1995). Despite these changes, rates of mental health service use are far below rates of mental health disorders (Dew, Dunn, Bromet, & Schulberg, 1988; Hirschfeld et al., 1997; Logan & King, 2001; Offer, Howard, Schonert, & Ostrov, 1991; Wu et al., 1999), especially among adolescents.
Can depression be a reluctant or unable to take responsibility for attending to multiple tasks?
Individuals anticipating a diagnosis of depression may also be reluctant or unable to take responsibility for attending to the multiple tasks (e.g., interacting with health care providers, adhering to treatment, self-monitoring symptoms, managing illness effects, engaging in healthy activities) required in managing a chronic disease (Brown et al., 2001).
Do primary care clinicians treat depression?
Although there is evidence that primary care clinicians tend to be sensitive to manifestations of depression in adults and provide appropriate treatment and follow-up services for them (Shye, Freeborn, & Mullooly, 2000), limited research exists on how adolescents fare. While adolescents surely face barriers to mental health care similar to those adults face, adolescents may face obstacles to treatment beyond those faced by adults.
Why are students undertreated for depression?
University students are another population that is undertreated for depression, largely due to the stigma surrounding mental health. 4 Doctoral student Leslie Rith-Najarian from the University of California in Los Angeles, and colleagues, conducted 2 parallel studies on large university campuses on the West (N=651) and East Coast (N=718) to determine how great the unmet need was for depression treatment in college students. 4
Why did men not seek help for depression?
As to why the men did not seek help for depression or sadness, the main themes focused on weakness and loss of masculinity for doing so. 3 Some examples of what provided relief for the men included speaking with women about their problems and experiencing trust during discussions. 3
What is patient centered culturally sensitive health care?
To help clinicians make more appropriate treatment choices, the Patient-Centered Culturally Sensitive Health Care is an assessment tool that enables them to see health disparities and how they can provide more individualized care. 1 Patients whose clinicians have used the tool reported higher satisfaction with their treatment. 1.
Why are working class men reluctant to seek treatment?
A study of working-class men (N=12; mean age, 40.42 years) found that they have difficulty acknowledging depression and are consequently reluctant to seek treatment, due to the social stigma. 3 The qualitative study conducted by psychologists James R. Mahalik, PhD, from Boston College, Chestnut Hill, Massachusetts, and Faedra R. Dagirmanjian, PhD, from Pace University, New York City, conducted in-depth interviews with men who worked in mostly male-dominated manual labor. 3
How to promote trust in a patient?
Use appropriate gestures (eg, fist bumps with children, nodding to encourage patients) and smile to project friendliness and promote trust. 5
Why is depression a paradox?
The paradox of depression treatment is that patients who most need it are often the ones who have difficulty accessing care due to stigma, attitudes toward mental health, and lack of access. Healthcare professionals need to adapt their approaches with different populations to ensure access to care.
Is depression a stigma?
Major depressive disorder (MDD) is often stigmatized, so it is not surprising that the disease goes undiagnosed and undertreated in certain populations. 1 Ethnic and racial minorities, as well as young people, may be challenged by their own attitudes toward seeking care for MDD.
Abstract
Even though safe and effective treatments for depression are available, many individuals with a diagnosis of depression do not obtain treatment. This study aimed to develop a tool to identify persons who might not initiate treatment among those who acknowledge a need.
Methods
We used data from the National Survey on Drug Use and Health (NSDUH), conducted annually by SAMHSA, which provides nationally representative data on substance abuse and mental illness in the U.S. civilian, noninstitutionalized population ages ≥12.
Results
We focused on adults who stated that they were diagnosed as having depression by a clinician in the past year (N=20,785). The gender and racial-ethnic breakdown of the cohort was as follows: female, 72%; male, 28%; white, 77%; Hispanic, 10%; black, 7%; multiracial, 4%; Asian, 1%; Native American, 1%; and Native Hawaiian/Pacific Islander, 1%.
Discussion and Conclusions
These data indicated that between 2008 and 2014, approximately 30% of U.S. individuals with 12-month major depressive disorder reported needing but not receiving mental health treatment.
What are the barriers to treatment?
Practical barriers include cost concerns (whether real or assumed), availability of transportation, not knowing where to go for treatment, etc. Psychological barriers include obstacles such as worries about stigmatization and doubts about the effectiveness of treatment.
Why don't people get treatment for depression?
The list of 15 reasons and endorsement rate for each is presented below (ordered from lowest to highest, based on endorsement rate): 1. Had no transportation or treatment too far (5.8 percent) 2. Didn’t want others to find out (6.5 percent)
What is a major depressive disorder?
Major depressive disorder is a mental disorder characterized by affective symptoms (e.g., depressed mood), cognitive symptoms (e.g., difficulty with concentration ), and somatic symptoms (e.g., appetite or weight changes). Not all depressed individuals who feel they require treatment for depression receive it.
What percentage of participants acknowledged the need for treatment, but received none of the sample?
Participants who acknowledged the need for treatment, but received none (30 percent of the sample), were provided a list of 15 potential justifications. They were asked: “Which of these statements explains why you did not get the mental health treatment or counseling you needed?”
What is the most predictive factor for not getting treatment?
The most predictive factor for not getting treatment was suicidal ideation. People who had been seriously considering killing themselves (e.g., making suicide plans) were less likely to seek treatment.
Why is aggressive outreach important?
Because low energy and a lack of motivation are essential features of depression, “aggressive outreach may be required to encourage some individuals to begin and remain in care ... and thus better targeting of patients in need of encouragement may make outreach cost-effective.”. article continues after advertisement.
Can depressed people endorse?
Some statements that depressed individuals endorsed could also reflect symptoms of depression; for example, it is understandable why a person with depression would endorse the pessimistic belief that treatments for depression will not work.