How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education

Promoting help-seeking for mental health problems can result in improved treatment rates. For the most impact, social marketing interventions need to be tailored to targeted demographic subgroups. We investigated the influence of interactions between attitudes toward treatment and age, gender, ethnicity/race and education for both general medical and specialty care. Cross-sectional data from the 2001-2003 National Comorbidity Survey Replication (NCS-R) were analyzed using multivariate models adjusted for the sampling design and controlled for relevant clinical and sociodemographic factors. Greater comfort talking to a professional was associated with greater past-year specialty care across all demographic groups, while strongest for non-Latino whites and not evident for those 50-64 years old. For all demographic groups, reported willingness to seek professional help was associated with general medical care. However, for specialty care the association was much stronger for men compared to women. For African Americans, but not non-Latino whites, the perceived efficacy of mental health treatment improved the likelihood of past-year specialty use. Our analyses suggest both the importance of understanding demographic differences in relevant attitudes and potential directions for marketing campaigns.