Psychiatric morbidity help-seeking and treatment in a multi- ethnic asian population

Abstract

BackgroundThe high psychiatric disorders in many countries pose a heavy societal burden and present an enormous need for services. There is a high volume of unmet needs, because most people with mental disorders do not seek professional help. Ethnic differences in psychiatric illneses and help seeking behaviour are also notable, and in multi-ethnic Singapore, differences in prevalence of psychiatric illness and under-utilization of mental health service pose a challenge to policy makers and health care authorities in planning for mental health services. Aims To assess the prevalence of mental disorders and help seeking behaviours and use of mental health service in the general population of Singapore and among different ethnic groups residing in Singapore, and to explore their differences in underlying beliefs and attitudes towards mental health services,MethodA two stage, population based mental health survey was conducted from February 2003 to March 2004, on a community sample of 2847 subjects in Singapore. Clinical and socio-demographic data were collected in the first stage using interviewer a?? administered questionnaires consisted of General Health Questionnaire (GHQ a?? 12) and other measures. Those subjects with poor self perceived general health (n = 883) proceeded to the second stage where the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) was administered to diagnose psychiatric morbidity. ResultsPsychiatric morbidity was diagnosed in 10.9% of Chinese, 9.0% of Indians and 5.4% of Malays. Malay subjects were significantly less likely to suffer from major depressive disorder and generalised anxiety disorder. 6.2% of Chinese, 5.5% of Indians and 5.2% of Malays sought help for mental health problems. Treatments for mental illness were received in 3.2% of Chinese, 1.9% of Indians and 1.3% of Malays. For all the respondents, the number of medical co- morbidity, poor self-rating on mental health status, self-reported mental illness and the clinical diagnosis of psychiatric disorder were significantly associated with help seeking behaviour from professionals, independently of socio-demographic variables. Fewer Malay subjects sought help and received treatment when they suffered from psychiatric morbidity and functional impairment. Malay respondents were more likely to perceive spiritual support as their main source of support, and were significantly more affected by embarrassment associated mental illness and lack of trust with professionals and medications. ConclusionsThese findings suggest that there is a difference in the use of mental health services among different ethnic groups due to differences in the prevalence of psychiatric illness and attitudes towards mental health services. This information is important for evaluating and reforming mental health services in societies with multi-ethnic Asian population.