Factors related to mental health service utilization among individuals with mental distress in the general population

Objective　To explore the factors associated with mental health service utilization by individuals with mental distress in the general population.Methods　Using the anonymous data of 97,345 individuals from the 2013 Comprehensive Survey of Living Conditions (Health and Household Cards), we considered from the working age population 17,077 (7,735 male, 9,342 female) between the ages of 15 and 65 years and having a score of 5 or more on the Kessler Psychological Distress Scale (K6)-an indicator of mental distress. We selected variables potentially associated with psychiatric visits (exposure factors), such as the K6 total score (5-24 points), age, sex, drinking and smoking status, number of households, average household spending per month, education and working status, and hospital visits for other diseases. We performed multivariate logistic regression analysis to estimate the adjusted odds ratio and 95% confidence interval of each exposure for consultation for "depression and other mental illnesses" at a medical institution.Results　Among the 17,077 participants, 914 (5.4%) reported that they were currently consulting a medical institution for mental health disorders. The higher the individuals' K6 total score, the higher was their likelihood of consulting a doctor for mental health disorders. Among those who reported consulting a doctor for mental illnesses, 58.3% were female, which was significantly higher than the female proportion in those who reported not consulting a doctor. The results of multivariate analysis showed drinking alcohol, living with a family of three or more people, and work, to be factors preventing mental illness service utilization, while being enrolled in high school or higher education, smoking, and consultations for other diseases were shown to be associated with a tendency to promote mental health care utilization.Conclusions　Using anonymous data from the 2013 Comprehensive Survey of Living Conditions, this study examined several background factors associated with mental health service utilization among a group with suspected mood and anxiety disorders. There is a necessity to create a social system that would allow the working population to consult a doctor for mental health disorders when needed, as well as receive information about mental illnesses.