Refraining from seeking mental healthcare and poorer mental well-being: A longitudinal population-based study on men in Sweden

Abstract Background: Depression and anxiety disorder contribute to a significant part of the disease burden among men, yet many men refrain from seeking care or receive insufficient care when they do seek it. This is plausibly detrimental to men’s mental well-being, but there is a lack of population-based research to confirm this. This study investigated 1) if men who had refrained from seeking mental healthcare had poorer mental well-being than those who sought care, 2) if those who sought care but perceived it as insufficient had poorer mental well-being than those who perceived care as sufficient, and 3) if these differences persisted after one year. Methods: This longitudinal study used questionnaire data from a population-based sample of 1240 men, aged 19-64 years, in Sweden. Having refrained from seeking mental healthcare, or perceiving the care as insufficient, at any time in life, was assessed in a questionnaire, 2008. Current mental well-being was assessed in 2008 and 2009 using mean scores on the WHO (Ten) Well-being Index, with a lower score indicating poorer mental well-being. Group differences were calculated using t-tests and multivariable linear regression analysis.Results: Of the men who had perceived a need for mental healthcare, 37% refrained from seeking such care. They had lower mental well-being scores in 2008, compared to those who sought care. Of those seeking care, 29 % perceived it as insufficient. They had lower mental well-being scores in 2008, compared to those who perceived the care as sufficient, but this was not statistically significant when controlling for potential confounders. There were no differences in mental well-being scores based on care-seeking or perceived care-sufficiency in 2009. Conclusions: This population-based study provides some support for the hypothesis that refraining from seeking mental healthcare, or perceiving the care as insufficient, is detrimental to men’s mental well-being. However, the lack of differences over time contradicts this hypothesis. The results highlight the need for larger longitudinal studies, measuring care-seeking within a more specified time frame, and using longer follow-up periods. This should be combined with efforts to increase men’s mental healthcare-seeking and to provide mental healthcare that is perceived as sufficient.