Perceived need for mental health care and service use among adults in Western Europe: results of the ESEMeD project.

OBJECTIVE: This study assessed prevalence and correlates of perceived need for mental health care and its role in help seeking. METHODS: Data were from general population surveys conducted for the European Study of the Epidemiology of Mental Disorders. The sample consisted of adults who screened positive for specific mood and anxiety symptoms in surveys conducted in Belgium, France, Germany, Italy, The Netherlands, and Spain (N=8,796). These individuals were further assessed for mental disorders with the Composite International Diagnostic Interview 3.0. Respondents who reported voluntary use of health services to address concerns with their "emotions or mental health" or who reported a need for services for mental health reasons were considered to have perceived need. RESULTS: Nine percent of the total sample perceived some need for mental health care in the past 12 months. Among those who had a mental disorder in the past 12 months, 33% had perceived need. Psychiatric morbidity was the major determinant of perceived need. Among those with perceived need, older age, nonurban residence, and residence in Germany were positively associated with use of services. CONCLUSIONS: Only a third of those with a 12-month mental disorder perceived need for mental health care. Psychiatric morbidity was the main determinant of perceived need; however, other factors (being female and being older) were associated with use of health services among those with perceived need. Among those with perceived need, it is important to increase access to care for the youngest and those living in urban areas.