Top

International Journal of Mental Health and Addiction

Published in:

22-07-2022 | Public Health | Original Article

Discovering Clusters of Support Utilization in the Canadian Community Health Survey–Mental Health

Authors: Maria Cutumisu, Jordan Southcott, Chang Lu

Published in: International Journal of Mental Health and Addiction | Issue 1/2024

Abstract

Mental illness is one of the most pressing medical challenges facing society. Thus, identifying gaps in mental-health support-seeking is crucial for public health. This exploratory study aims to reveal gaps and patterns in mental-healthcare support-utilization by employing unsupervised machine learning in the Canadian Community Health Survey–Mental Health that measures support-seeking for mental-health issues from 24,788 Canadians. Of the clustering methods compared (K-means, hierarchical agglomerative, and Fuzzy C-means), Fuzzy C-means clustering yielded the best model fit for the data and revealed four clusters: No Support, Social Support, Professional Support, and Mixed Support evaluated based on existing theory. Findings reveal differential effects by all variables, except for the variable concerning whether a respondent was white or a visible minority.

Available only for authorised users

Andersen, R., & Davidson, P. (2007). Improving access to care in America: Individual and contextual indicators. In: R. M. Andersen, T. H. Rice, E. F. Kominski (Eds.). Changing the U.S. Health Care System: Key Issues in Health Services, Policy, and Management. 3^rd Edition. San Francisco, CA: Jossey-Bass; 2001. pp. 3–30. ISBN: 9780787985240.

Baluck, T. A. (2018). Mediating effect of masculinity and femininity on the female preponderance in depression [dissertation] (p. 2018). Eastern Michigan University.

Bardach, S. H., Tarasenko, Y. N., & Schoenberg, N. E. (2011). The role of social support in multiple morbidity: Self-management among rural residents. Journal of Health Care for the Poor and Underserved, 22(3), 756–771. https://doi.org/10.1353/hpu.2011.0083CrossRefPubMedPubMedCentral

Bartram, M., & Stewart, J. M. (2019). Income-based inequities in access to psychotherapy and other mental health services in Canada and Australia. Health Policy, 123(1), 45–50. https://doi.org/10.1016/j.healthpol.2018.10.011CrossRefPubMed

Bass, S. B., Muñiz, J., Gordon, T. F., et al. (2016). Understanding help-seeking intentions in male military cadets: An application of perceptual mapping. BMC Public Health, 16, 413. https://doi.org/10.1186/s12889-016-3092-zCrossRefPubMedPubMedCentral

Bilsker, D., Fogarty, A. S., & Wakefield, M. A. (2018). Critical issues in men’s mental health. The Canadian Journal of Psychiatry, 63(9), 590–596. https://doi.org/10.1177/0706743718766052CrossRefPubMed

Cadzow, R. B., & Servoss, T. J. (2009). The association between perceived social support and health among patients at a free urban clinic. Journal of the National Medical Association, 101(3), 243–250. https://doi.org/10.1016/s0027-9684(15)30852-xCrossRefPubMed

Cheung, A., Dewa, C., Cairney, J., Veldhuizen, S., & Schaffer, A. (2009). Factors associated with use of mental health services for depressed and/or suicidal youth aged 15–24. Community Mental Health Journal, 45, 300–306. https://doi.org/10.1007/s10597-009-9205-8CrossRefPubMed

Cole, B. P., & Ingram, P. B. (2019). Where do I turn for help? Gender role conflict, self-stigma, and college men’s help-seeking for depression. Psychology of Men & Masculinities. https://doi.org/10.1037/men0000245CrossRef

Cox, D. W. (2014). Gender differences in professional consultation for a mental health concern: A Canadian population study. Canadian Psychology/psychologie Canadienne, 55(2), 68–74. https://doi.org/10.1037/a0036296CrossRef

Delaunois, I., Morgan, M., & Leen, B. (2020). Do men between the ages of 18–65 years of age with depression experience difficulty accessing mental health services and support? [v1. 0]. Retrieved on July 16, 2022 from: https://www.lenus.ie/bitstream/handle/10147/629380/Evidence%20Summary%20COVID-19%20Depression%20in%20Men%2018-65%20years.pdf?sequence=1

Dunn, J. C. (1973). A fuzzy relative of the ISODATA process and its use in detecting compact well-separated clusters. Journal of Cybernetics, 3(3), 32–57. https://doi.org/10.1080/01969727308546046MathSciNetCrossRef

Duong, M. T., Bruns, E. J., Lee, K., Cox, S., Coifman, J., Mayworm, A., & Lyon, A. R. (2021). Rates of mental health service utilization by children and adolescents in schools and other common service settings: A systematic review and meta-analysis. Administration and Policy in Mental Health and Mental Health Services Research, 48, 420–439. https://doi.org/10.1007/s10488-020-01080-9CrossRefPubMed

Ebbert, D. (2019). chisq.posthoc.test: A Post Hoc Analysis for Pearson's Chi-Squared Test for Count Data. R package version 0.1.2. https://CRAN.R-project.org/package=chisq.posthoc.test

Findlay, L. C., & Sunderland, A. (2014). Professional and informal mental health support reported by Canadians aged 15 to 24. Statistics Canada, Catalogue no. 82–003-X, 25(12), 3–11.

Fiori, K., & Denckla, C. (2012). Social support and mental health in middle-aged men and women: A multidimensional approach. Journal of Aging and Health, 24(3), 407–438. https://doi.org/10.1177/0898264311425087CrossRefPubMed

Fleury, M., Nguim, A. N., Bamvita, J., Grenier, G., & Caron, J. (2014). Predictors of healthcare service utilization for mental health reasons. International Journal of Environmental Research and Public Health, 11(10), 10559–10586. https://doi.org/10.3390/ijerph111010559CrossRefPubMedPubMedCentral

Gale, J., Janis, J., Coburn, A., & Rochford, H. (2019). Behavioural health in rural America: Challenges and opportunities. Retrieved on July 16, 2022 from http://www.rupri.org/wp-content/uploads/Behavioral-Health-in-Rural-America-Challenges-and-Opportunities.pdf

Goodwin, R. D., Hoven, C. W., Lyons, J. S., & Stein, M. B. (2002). Mental health service utilization in the United States. Social Psychiatry and Psychiatric Epidemiology, 37(12), 561–566. https://doi.org/10.1007/s00127-002-0563-6CrossRefPubMed

Government of Canada. (2020). Mental Illness. Retrieved on July 16, 2022 from https://www.canada.ca/en/public-health/services/chronic-diseases/mental-illness.html#shr-pg0

Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 10(113). https://doi.org/10.1186/1471-244X-10-113

Guntuku, S. C., Schwartz, H. A., Kashyap, A., Gaulton, J. S., Stokes, D. C., Asch, D. A., Ungar, L. H., & Merchant, R. M. (2020). Variability in language used on social media prior to hospital visits. Scientific Reports, 10(1), 1–9. https://doi.org/10.1038/s41598-020-60750-8CrossRef

Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F. (2005). Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of General Psychiatry, 62(10), 1097–1106. https://doi.org/10.1001/archpsyc.62.10.1097CrossRefPubMed

Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental illness stigma, help seeking, and public health programs. American Journal of Public Health, 103(5), 777–780. https://doi.org/10.2105/AJPH.2012.301056CrossRefPubMedPubMedCentral

House, J., Marasli, P., Lister, M., & Brown, J. S. (2018). Male views on help-seeking for depression: A Q methodology study. Psychology and Psychotherapy: Theory, Research and Practice, 91(1), 117–140. https://doi.org/10.1111/papt.12144CrossRef

Islam, F. (2014). Mental Health and Mental Healthcare Utilization in Canada’s Immigrant and Ethnocultural Populations [dissertation]. York University.

Islam, F., Khanlou, N., Macpherson, A., & Tamim, H. (2018). Mental health consultation among Ontario’s immigrant populations. Community Mental Health Journal, 54, 579–589. https://doi.org/10.1007/s10597-017-0210-zCrossRefPubMed

Jang, Y., Chiriboga, D. A., & Okazaki, S. (2009). Attitudes toward mental health services: Age-group differences in Korean American adults. Aging & Mental Health, 13(1), 127–134. https://doi.org/10.1080/13607860802591070CrossRef

Kantor, V., Knefel, M., & Lueger-Schuster, B. (2017). Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: A systematic review. Clinical Psychology Review, 52, 52–68. https://doi.org/10.1016/j.cpr.2016.12.001CrossRefPubMed

Kassambara, A., & Mundt, F. (2020). factoextra: Extract and visualize the results of multivariate data analyses. R Package Version 1.0.7. Retrieved on July 16, 2022 from https://CRAN.R-project.org/package=factoextra

Kielland, N., & Simeone, T. (2014). Current issues in mental health in Canada: The mental health of First Nations and Inuit communities. Library of Parliament, Publication No. 2014-02-E. Retrieved from https://lop.parl.ca/staticfiles/PublicWebsite/Home/ResearchPublications/InBriefs/PDF/2014-02-e.pdf

Kirmayer, L. J., Weinfeld, M., Burgos, G., du Fort, G. G., Lasry, J. C., & Young, A. (2007). Use of health care services for psychological distress by immigrants in an urban multicultural milieu. Canadian Journal of Psychiatry, 52(5), 295–304. https://doi.org/10.1177/070674370705200504CrossRefPubMed

Levant, R. F., Stefanov, D. G., Rankin, T. J., Halter, M. J., Mellinger, C., & Williams, C. M. (2013). Moderated path analysis of the relationships between masculinity and men’s attitudes toward seeking psychological help. Journal of Counseling Psychology, 60(3), 392–406. https://doi.org/10.1037/a0033014CrossRefPubMed

Lynch, L., Long, M., & Moorhead, A. (2018). Young men, help-seeking, and mental health services: Exploring barriers and solutions. American Journal of Men’s Health, 12(1), 138–149. https://doi.org/10.1177/1557988315619469.PMID:27365212;PMCID:PMC5734535CrossRefPubMed

MacDonald, K. (2022). Young people’s mental health service use and pathways to care. Dissertation. McGill University. Retrieved on July 16, 2022 from https://escholarship.mcgill.ca/downloads/8910k033g

McAlpine, D., & Mechanic, D. (2000). HSR utilization of specialty mental health care among persons with severe mental illness: The roles of demographics, need, insurance, and risk. Health Services Research, 35(1), 277–292.PubMedPubMedCentral

McKenzie, S. K., Collings, S., Jenkin, G., & River, J. (2018). Masculinity, social connectedness, and mental health: Men’s diverse patterns of practice. American Journal of Men’s Health, 12(5), 1247–1261. https://doi.org/10.1177/1557988318772732CrossRefPubMedPubMedCentral

Meng, X., Liu, A., D’Arcy, C., & Caron, J. (2020). Baseline income, follow-up income, income mobility and their roles in mental disorders: A longitudinal intra-generational community-based study. BMC Psychiatry, 20(181), 1–8. https://doi.org/10.1186/s12888-020-02578-0CrossRef

Mental Health Commission of Canada, (2013) Making the Case for Investing in Mental Health in Canada. Retrieved on July 16, 2022 from https://www.mentalhealthcommission.ca/sites/default/files/2016-06/Investing_in_Mental_Health_FINAL_Version_ENG.pdf

Meyer, D., Dimitriadou, E., Hornik, K., Weingessel, A., & Leisch, F. (2019). e1071: Misc Functions of the Department of Statistics, Probability Theory Group. TU Wien. R package version 1.7–3. Retrieved on July 16, 2022 from https://CRAN.R-project.org/package=e1071

Montiel, C., Duhoux, A., Tremblay, G., Villeneuve, R., Roy, J., Lavoie, B., & Houle, J. (2022). Psychological distress and Help-seeking facilitators in Quebec men: Findings from a province-wide survey. International Journal Men’s Social and Community Health, 5(1), e1–e26. https://doi.org/10.22374/ijmsch.v5i1.57CrossRef

Morgan, K., Bullmore, H., & Lawton-Smith, S. (2012). Life lines: Evaluation of mental health helplines. Retrieved on July 16, 2020 from https://www.bl.uk/britishlibrary/~/media/bl/global/social-welfare/pdfs/non-secure/l/i/f/life-lines-evaluation-of-mental-health-helplines.pdf

Ngamini Ngui, A., Perreault, M., Fleury, M. J., & Caron, J. (2012). A multi-level study of the determinants of mental health service utilization. Revue D’epidémiologie Et De Santé Publique, 60(2), 85–93. https://doi.org/10.1016/j.respe.2011.09.007CrossRefPubMed

O’Donnell, S., & Richardson, N. (2020). No country for middle-aged men? An intersectional approach to explore sources of psychological distress and patterns of seeking support among middle-aged men considered ‘at risk’of suicide in Ireland. International Journal of Men’s Social and Community Health, 3(2), e32–e45.CrossRef

R Core Team. (2021). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/

Rice, S. M., Oliffe, J. L., Kealy, D., Seidler, Z. E., & Ogrodniczuk, J. S. (2020). Men’s help-seeking for depression: Attitudinal and structural barriers in symptomatic men. Journal of Primary Care & Community Health. 11. https://doi.org/10.1177/2150132720921686

Rickwood, D., Deane, F., & Wilson, C. (2007). When and how do young people seek professional help for mental health problems? The Medical Journal of Australia, 187, S35–S39. https://doi.org/10.5694/j.1326-5377.2007.tb01334.xCrossRefPubMed

Rickwood, D. J., Mazzer, K. R., & Telford, N. R. (2015). Social influences on seeking help from mental health services, in-person and online, during adolescence and young adulthood. BMC Psychiatry, 15(40), 1–9. https://doi.org/10.1186/s12888-015-0429-6CrossRef

Roberts, T., Miguel Esponda, G., Krupchanka, D., Shidhaye, R., Patel, V., & Rathod, S. (2018). Factors associated with health service utilisation for common mental disorders: A systematic review. BMC Psychiatry, 18(262), 1–19. https://doi.org/10.1186/s12888-018-1837-1CrossRef

Rousseeuw, P. J. (1973). Silhouettes: A graphical aid to the interpretation and validation of cluster analysis. Journal of Computational and Applied Mathematics, 20, 53–65. https://doi.org/10.1016/0377-0427(87)90125-7CrossRef

Saha, K., Yousuf, A., Boyd, R., Pennebaker, J. W., & De Choudhury, M. (2021). Mental health consultations on college campuses: Examining the predictive ability of social media. Lancet. https://doi.org/10.21203/rs.3.rs-196605/v1CrossRefPubMedPubMedCentral

Sawyer, S. M., Azzopardi, P. S., Wickremarathne, D., & Patton, G. C. (2018). The age of adolescence. The Lancet Child & Adolescent Health, 2(3), 223–228. https://doi.org/10.1016/S2352-4642(18)30022-1CrossRef

Schlax, J., Jünger, C., Beutel, M. E., Münzel, T., Pfeiffer, N., Wild, P., . . . Michal, M. (2019). Income and education predict elevated depressive symptoms in the general population: Results from the Gutenberg health study. BMC Public Health, 19(430), 1-10.https://doi.org/10.1186/s12889-019-6730-4

Schomerus, G., Van der Auwera, S., Matschinger, H., Baumeister, S. E., & Angermeyer, M. C. (2015). Do attitudes towards persons with mental illness worsen during the course of life? An Age-Period-Cohort Analysis. Acta Psychiatrica Scandinavica, 132(5), 357–364. https://doi.org/10.1111/acps.12401CrossRefPubMed

Seidler, Z. E., Rice, S. M., Kealy, D., Oliffe, J. L., & Ogrodniczuk, J. S. (2020). Once bitten, twice shy: Dissatisfaction with previous therapy and its implication for future help-seeking among men. International Journal of Psychiatry in Medicine, 55(4), 255–263. https://doi.org/10.1177/0091217420905182CrossRefPubMed

Slaunwhite, A. K. (2015). The role of gender and income in predicting barriers to mental health care in Canada. Community Mental Health Journal, 51(5), 621–627. https://doi.org/10.1007/s10597-014-9814-8CrossRefPubMed

Southcott, J. (2021). Validation and pattern discovery in the Canadian community health survey-mental health (CCHS-MH) support utilization. University of Alberta.

Staiger, T., Stiawa, M., Mueller-Stierlin, A. S., Kilian, R., Beschoner, P., Gündel, H., Becker, T., Frasch, K., Panzirsch, M., Schmauß, M., & Krumm, S. (2020). Men and depression: Illness theories and coping - A biographical narrative study. Psychiatrische Praxis, 47(2), 65–70. https://doi.org/10.1055/a-1043-8126CrossRefPubMed

Statistics Canada. (2013). Dataset: Canadian Community Health Survey, 2012: Mental Health Component.

Statistics Canada. (2014). Table 13–10–0465–01, Mental health indicators. Retrieved on July 16, 2022 from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310046501

Statistics Canada. (2019). Mental health care needs. Retrieved on July 16, 2022 from https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00011-eng.htm

Statistics Canada LICO. (2020). Table 11–10–0195–01. Low income cut-offs (LICOs) before and after tax by community size and family size, in constant dollars. Retrieved from https://doi.org/10.25318/1110019501-eng

Statistics Canada MBM. (2020). Table 11–10–0066–01 Market Basket Measure (MBM) thresholds for the reference family by Market Basket Measure region, component and base year. Retrieved from https://doi.org/10.25318/1110006601-eng

Stiawa, M., Müller-Stierlin, A., Staiger, T., Kilian, R., Becker, T., Gündel, H., Beschoner, P., Grinschgl, A., Frasch, K., Schmauß, M., Panzirsch, M., Mayer, L., Sittenberger, E., & Krumm, S. (2020). Mental health professionals view about the impact of male gender for the treatment of men with depression—A qualitative study. BMC Psychiatry, 20(276), 1–13. https://doi.org/10.1186/s12888-020-02686-xCrossRef

Sunderland, A., & Findlay, L. C. (2013). Perceived need for mental health care in Canada: Results from the 2012 Canadian Community Health Survey–Mental Health. Component of Statistics Canada Catalogue no. 82–003-X Health Reports, 24(9), 3–9. Retrieved on July 16, 2022 from: https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2013009/article/11863-eng.pdf?st=iFumG7o_

Tibshirani, R., Walther, G., & Hastie, T. (2001). Estimating the number of clusters in a data set via the gap statistic. Journal of the Royal Statistical Society: Series B (statistical Methodology), 63(2), 411–423. https://doi.org/10.1111/1467-9868.00293MathSciNetCrossRef

Turcotte, M. (2005). Social engagement and civic participation: Are rural and small town populations really at an advantage? Rural and Small Town Canada Analysis Bulletin, Catalogue no. 21–006-XIE, 6(4). Retrieved on July 16, 2022 from: https://www150.statcan.gc.ca/n1/en/pub/21-006-x/21-006-x2005004-eng.pdf?st=rPx3OYDj

Wang, J., Mann, F., Lloyd-Evans, B., Ma, R., & Johnson S. (2018). Associations between loneliness and perceived social support and outcomes of mental health problems: A systematic review. BMC Psychiatry, 8(156). https://doi.org/10.1186/s12888-018-1736-5

Watson, A. C., Miller, F. E., & Lyons, J. S. (2005). Adolescent attitudes toward serious mental illness. Journal of Nervous & Mental Disorders, 193(11), 769–772. https://doi.org/10.1097/01.nmd.0000185885.04349.99CrossRef

Wirback, T., Forsell, Y., Larsson, J.-O., Engström, K., & Edhborg, M. (2018). Experiences of depression and help-seeking described by young Swedish men. Psychology of Men & Masculinity, 19(3), 407–417. https://doi.org/10.1037/men0000110CrossRef

Title: Discovering Clusters of Support Utilization in the Canadian Community Health Survey–Mental Health
Authors: Maria Cutumisu
Jordan Southcott
Chang Lu
Publication date: 22-07-2022
Publisher: Springer US
Keyword: Public Health
Published in: International Journal of Mental Health and Addiction / Issue 1/2024
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI: https://doi.org/10.1007/s11469-022-00880-4

At a glance: The STEP trials

Springer Medicine

Discovering Clusters of Support Utilization in the Canadian Community Health Survey–Mental Health

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2024

Loyalty Program Rewards Increases Willingness to Use Responsible Gambling Tools and Attitudinal Loyalty

Exploring the Patterns of Substance Use Behaviors in a Nationally Representative Sample of Pregnant Women: a Latent Class Approach

The Smartphone Addiction Scale: Psychometric Properties, Invariance, Network Perspective, and Latent Profile Analysis Among a Sample of Chinese University Students

How Does Family Dysfunction Influence Internet Gaming Disorder? Testing a Moderated Serial Mediation Model Among Chinese Adolescents

Application of Machine Learning Techniques to Help in the Feature Selection Related to Hospital Readmissions of Suicidal Behavior

Impaired Outcome Evaluation During Risky Decision-Making in Individuals with Methamphetamine Use Disorder