Psychological barriers prevent some mentally ill from seeking help

December 01, 2001

More than 60 percent of individuals with serious mental illness may not be receiving treatment, and contrary to previous research, the rural mentally ill are more likely to get treatment than their urban counterparts, according to a new study.

"The majority of untreated people with serious mental illness do not believe they have emotional problems requiring treatment, and most of those who recognize they need help prefer to deal with the problem on their own," says lead study author Ronald C. Kessler, Ph.D., a professor at Harvard Medical School and at the Institute for Social Research at the University of Michigan.

An estimated 10 million Americans meet criteria for serious mental illness according to the study, published in the December issue of Health Services Research.

Efforts to reform mental health care tend to focus on barriers like not having the money for treatment or not knowing where to find treatment, says Kessler, arguing for a broader approach. "Overhauling the existing treatment system to reduce financial and situational barriers is unlikely, by itself, to reduce unmet need entirely," the researcher says.

Kessler and colleagues examined data from the National Comorbidity Survey, a household survey of more than 8,000 individuals age 15 to 54, designed to diagnose mental illness. About 6 percent of those surveyed had a serious mental illness such as panic disorder, post traumatic stress disorder, major depression, manic depression, schizophrenia or another mental disorder resulting in serious personal problems, work disruptions or suicide attempts or plans.

During the year before they were surveyed, 62.8 percent of the seriously mentally ill respondents received no stable treatment from a professional such as a psychiatrist or other medical doctor, nurse, psychologist, social worker or counselor, the researchers found. Of that population, 46.2 percent received no treatment and 16.6 percent dropped out of treatment.

A majority of the untreated seriously mentally illness individuals felt they did not have an emotional problem. Untreated individuals who recognized they had a problem most often said they would rather address their problem themselves than seek treatment. Other treatment barriers included not knowing where to find treatment, money problems and lack of confidence that treatment would help, the researchers found.

Kessler and colleagues noted that younger seriously mentally ill individuals (age 18 to 34) were heavily represented in the untreated category.

Contrary to previous research, Kessler and colleagues found rural individuals were more likely than others to receive treatment, and less likely to report stigma as a treatment barrier. "This finding clashes with the naïve notion that concerns about what the neighbors think are greater in rural than urban areas," Kessler says.

Kessler and colleagues note that their research didn't include homeless or institutionalized individuals, and their definition of serious mental illness was narrow--so their estimated prevalence of serious mental illness is probably conservative. Also, their study data were collected in the early 1990s, before the rise of new antidepressant and antipsychotic medications and of the managed care industry.
This research was supported by grants from the National Institute of Mental Health, the National Institute of Drug Abuse, and the W.T. Grant Foundation.

Health Services Research is the bimonthly peer-reviewed journal of the Academy for Health Services Research and Health Policy and is owned by Health Research and Educational Trust. For information about the journal, contact Alice Schaller at (510) 643-5439 or email

Posted by the Center for the Advancement of Health ( For more research news and information, go to our special section devoted to health and behavior in the "Peer-Reviewed Journals" area of Eurekalert!, For information about the Center, call Ira Allen,, (202) 387-2829.

Center for Advancing Health

Related Mental Illness Articles from Brightsurf:

Mental illness, mental health care use among police officers
A survey study of Texas police officers examines how common mental illness and mental health care use are in a large urban department.

Hospitals miss mental illness diagnosis in more than a quarter of patients
Severe mental illness diagnoses are missed by clinicians in more than one quarter of cases when people are hospitalised for other conditions, finds a new study led by UCL researchers, published in PLOS Medicine.

Young migrants at risk of mental illness
Experience of trauma, abuse and poverty puts the mental health of many young refugees at risk.

Chronic illness in childhood linked to higher rates of mental illness
Children with long-term health conditions may be more likely to experience mental illness in early adolescence than healthy children, according to new research from Queen Mary University of London.

Did 'Joker' movie perpetuate prejudices against those with mental illness?
Researchers in this survey study examined whether watching the 2019 movie 'Joker,' in which the namesake character is violent and has mental illness, was associated with a change in the level of prejudice toward people with mental illness compared with others who watched another movie.

Skills training opens 'DOORS' to digital mental health for patients with serious mental illness
Digital technologies, especially smartphone apps, have great promise for increasing access to care for patients with serious mental illness such as schizophrenia.

Research calls for new measures to treat mental illness and opioid use
Opioid use among psychiatric hospital patients needs to be addressed through an integrated approach to managing mental illness, pain and substance use, a study by researchers at the University of Waterloo has found.

Researchers challenge myth of the relationship between mental illness and incarceration
Researchers examined the relationship between psychiatric diagnoses and future incarceration by merging data from psychiatric interviews that took place in the 1980s with 30 years of follow-up data.

New research raises important questions on how mental illness is currently diagnosed
This research raises questions as to whether current diagnoses accurately reflect the underlying neurobiology of mental illness.

Young teens of color more likely to avoid peers with mental illness
Students identifying as black or Latino are more likely to say they would socially distance themselves from peers with a mental illness, a key indicator of mental illness stigma, according to research published by the American Psychological Association.

Read More: Mental Illness News and Mental Illness Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to