Depression, Problem Recognition, and Professional Consultation

Data are from a 1979 community sample (n = 1000) of adults in Los Angeles County. The analysis examines how depressive symptoms, measured with the Center for Epidemiologic Studies Depression (CES-D) scale, and a variety of other factors influence problem recognition and use of mental health services. Of those people with a high level of depressive symptoms, nearly one third view themselves as having a nondepressive problem, while another third view themselves as having no personal problem. After controlling for demographic and other factors, depressive symptoms emerge as the most important element enhancing problem recognition; being female and having more education also enhance recognition of depressive problems and enable people to distinguish depressive from other problems. Among those with a high level of depressive symptoms, only one third had consulted a mental health service in the prior year. Factors promoting use of mental health services among those who acknowledge a personal problem include depressive symptoms, prior use of mental health services, use of services by friends and relatives, and discussion with friends and relatives about counseling; no significant effects emerge for sex, age, education, income, or insurance coverage. Data from the untreated show that a self-reliant attitude and some practical barriers prevent people with depressive symptoms from obtaining professional help.