The use of mental health services among young adults with emotional and behavioural problems: equal use for equal needs

Objective Mental health problems are highly prevalent in young adults. Despite possibilities for effective treatment, only about one-third of young adults with mental health problems seek professional help. Little knowledge exists of which groups of young adults are underusing mental health services and for what reasons. The present study examined sociodemographic inequalities in the use of mental health services by young adults, and examined whether such inequalities were attributable to differences in objective need, subjective need, predisposing or enabling factors. Design Cross-sectional study among the general population aged 19–32 years (2,258 respondents). A postal survey was administered including questions on socio-demographic factors and mental health service use. Data were analyzed with logistic regression analysis. Setting South–West Netherlands. Participants All respondents with serious internalizing and externalizing problems (n = 367). Main outcome measure Twelve-month primary and specialty mental health services use. Results Only 34.6% of young adults with psychopathology had used any mental health services: 16.2% had used only primary mental health services and 18.4% had used specialty mental health services. No socio-demographic differences were found in the use of only primary mental health services. However, recipients of specialty mental health services were more often female (OR = 2.12, 95% CI = 1.14–3.96), economically inactive (OR = 3.12, 95% CI = 1.59–6.09) or students (OR = 2.38, 95% CI = 1.05–5.42) and they were less often higher educated (OR = 0.49, 95% CI = 0.25– 0.97). The higher odds ratio for specialty service use among young adults who were female or economically inactive attenuated when adjusting for need for care. The other socio-demographic disparities in specialty service use did not attenuate when adjusting for need, enabling or predisposing factors. Conclusion Among young adults, equal use of specialty mental health services for equal needs has not been achieved. The underserved groups of young adults oppose the traditionally underserved groups in the general population, and may inform interventions aimed at improving young people’s help-seeking behaviours.