Depression: An undertreated disorder?

In 1994, an estimated 6% of Canadians aged 18 and over—1.1 mi l l ion adults—experienced a Major Depressive Episode (MDE). Although depression is amenable to treatment, fewer than half (43%) the people who met the criteria of having experienced an MDE in the past year (approximately 487,000) reported talking to a health professional about their emotional or mental health. Furthermore, only 26% of those who had an MDE reported four or more such consultations. As expected, depression that was not chronic was more likely to be untreated. In addition, MDE sufferers whose physical health was good and those who had not recently experienced a negative life event were less likely to be treated. However, after controlling for these factors, a multivariate model suggests that lower educational attainment and inadequate income acted as barriers to treatment. Relatively few contacts with a general practitioner substantially reduced the odds of being treated. Also, men and married people who were depressed were less likely to receive treatment. With data from Statistics Canada’s 1994-95 National Population Health Survey (NPHS), this article examines the characteristics of people who met the criteria for having had an MDE, but who discontinued or did not receive treatment. The selection of explanatory variables was informed by an established theoretical framework of individual determinants of health service utilization, proposed by Andersen and Newman. Logistic regression was used to predict the probability of not being treated among people who experienced an MDE.