Who has mental health problems? Comparing individual, social and psychiatric constructions of mental health

Purpose The persistent gap between population indicators of poor mental health and the uptake of services raises questions about similarities and differences between social and medical/psychiatric constructions. Rarely do studies have assessments from different perspectives to examine whether and how lay individuals and professionals diverge. Methods Data from the Person-to-Person Health Interview Study (P2P), a representative U.S. state sample (N similar to 2700) are used to examine the overlap and correlates of three diverse perspectives-self-reported mental health, a self/other problem recognition, and the CAT-MH (TM) a validated, computer adaptive test for psychopathology screening. Descriptive and multinominal logit analyses compare the presence of mental health problems across stakeholders and their association with respondents' sociodemographic characteristics. Results Analyses reveal a set of socially constructed patterns. Two convergent patterns indicate whether there is (6.9%, The Sick) or is not (64.6%, The Well) a problem. The Unmet Needers (8.7%) indicates that neither respondents nor those around them recognize a problem identified by the screener. Two patterns indicate clinical need where either respondents (The Self Deniers, 2.9%) or others (The Network Deniers, 6.0%) do not. Patterns where the diagnostic indicator does not suggest a problem include The Worried Well (4.9%) where only the respondent does, The Network Coerced (4.6%) where only others do, and The Prodromal (1.4%) where both self and others do. Education, gender, race, and age are associated with social constructions of mental health problems. Conclusions The implications of these results hold the potential to improve our understanding of unmet need, mental health literacy, stigma, and treatment resistance.

Automated summary

This study examines the similarities and differences between social and medical/psychiatric constructions of mental health problems through analyzing data from different perspectives. The results reveal socially constructed patterns and show the associations between sociodemographic characteristics and social constructions of mental health problems.