Socioeconomic status and self-reported barriers to mental health service use

Leah Steele, Carolyn S Dewa, Kenneth Lee

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


Objective: Socially disadvantaged individuals are at high risk for having their mental health service needs unmet. We explored the relations among education level, income level, and self-reported barriers to mental health service use for individuals with a mental illness, using data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). Methods: Our sample group comprised the 8.3% of adult respondents who met the CCHS 1.2 criteria for an anxiety or affective disorder in the past 12 months (n = 3101). We examined the association between education and income levels and self-reported accessibility, availability, or acceptability barriers to mental health care. Results: Accessibility, availability, and acceptability barriers were reported by 3%, 5%, and 16% of our sample, respectively. Individuals with a high school diploma were less likely than individuals without a high school diploma to report acceptability barriers to care (odds ratio 0.65; 95% confidence interval, 0.45 to 0.93). Higher-income individuals were less likely than lower-income individuals to report acceptability barriers to care (odds ratio 0.69; 95% confidence interval, 0.50 to 0.96). Employment, distress level, age, and family structure were also associated with acceptability barriers. Conclusion: Issues related to acceptability explain most of the unmet need for mental health services. Program planners should consider the development of targeted approaches to service delivery and outreach for low-income, working individuals who have not completed high school.

Original languageEnglish (US)
Pages (from-to)201-206
Number of pages6
JournalCanadian Journal of Psychiatry
Issue number3
StatePublished - Mar 2007
Externally publishedYes


  • Health services accessibility
  • Mental health services
  • Socioeconomic status

ASJC Scopus subject areas

  • Psychiatry and Mental health


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