Research reportUnmet depression information needs in the community
Introduction
High quality consumer health information is believed to improve self-management (Coulter et al., 1999), facilitate shared decision making and consumer empowerment (Coulter et al., 1999, Garfield et al., 2004), improve adherence to treatment (Bowskill et al., 2007) and improve mental health (Donker et al., 2009). It is not surprising then that clinical practice guidelines typically emphasise the importance of providing information to mental health consumers (National Institute for Clinical Excellence, 2009, National Institute for Clinical Excellence, 2011)
However, a number of researchers have reported significant levels of unmet information needs among service users with a mental illness. In an Australian national community survey, 39.4% of respondents who had consulted a GP, psychologist or psychiatrist for a mental health problem reported an unmet or only partially met need for information about their condition (Meadows and Bobevski, 2011). In a Dutch study focusing on people with depression and anxiety disorders in primary care, one-third of the participants reported an unmet or only partially met need for information about their condition (Prins et al., 2008). Powell and Clarke (2006) in a qualitative study found that service users with mild to moderate mental health problems reported a lack of information about diagnosis and treatment options including side effects of medication. Similarly, other studies have reported consumer dissatisfaction with the information that health professionals provide about mental illness including its nature, course and treatment (Fossey et al., 2012) and about antidepressants and other psychotropic medications (Bell et al., 2006, Bowskill et al., 2007, Fossey et al., 2012, Garfield et al., 2004, Happell et al., 2004, Pollock et al., 2004).
With the advent of the Internet and a proliferation of information about the common mental disorders in books, brochures, and newspapers, consumers are not solely reliant on health professionals to satisfy their mental health information needs (Pohjanoksa-Mäntylä et al., 2011, Tanenbaum, 2008). However, mental health educational resources are rarely informed by a consideration of consumer-reported needs (Chien et al., 2001, Powell and Clarke, 2006). Appropriately targeted information is important not only for consumers with mental illness but also for members of the community since mental health literacy is likely to assist individuals to recognise and act on the early signs of mental illness in themselves should it occur in the future, facilitate help seeking, and provide support to others (Gulliver et al., 2012, Kitchener and Jorm, 2002). However, to our knowledge there have been no investigations of the level and type of mental health information needs of the general community.
Given that depression is the primary cause of disability internationally (World Health Organization, 2008), there is a particular need to ensure that adequate depression information is available for all members of the community. The current study seeks to (i) determine what these information needs are; and (ii) identify the predictors of different types of information need in the community. Since there are currently no formal measures of depression information needs the study also sought to (iii) develop a formal measure of information need for depression (the Depression Information Needs Scale).
Section snippets
Method
Depression information needs were investigated using a hard copy survey mailed to members of the general community in rural and metropolitan Australia. The survey was designed for the joint purposes of investigating mental health needs, attitudes and knowledge among Australians and to identify a subset of participants who might be suitable for recruitment to an online intervention study for depression (Griffiths et al., 2010). The latter is not the subject of the current paper. To promote broad
Sample characteristics:
The characteristics of the sample are summarised in Table 1. Participants represented a broad age range, and were predominantly female, married and employed. Over half were from rural or remote regions, fewer than half university educated and most participants had access to the Internet from home or work. Twenty-percent of the participants self-reported current depression.
Level of unmet need (individual items)
Table 2 summarises the percentage of participants self-reporting a need for information about depression for each of the 21
Discussion
There were four main findings from this study. First there was a high level of unmet need in the community for information about a broad range of depression topics with between 50 and 75% of participants in the current study endorsing the need for more information on each of the 21 information need topics. Second, it was found that these information needs could be grouped, based on principal components analysis into four components: General, Lived Experience, Research and Policies, and Specific
Role of funding source
This study was funded by a National Health and Medical Research Council (NHMRC) Project Grant 471435. K.G. is supported by NHMRC Fellowship no. 525413. The funding body played no further role in any aspect of this study.
Conflict of interest
Both authors declare that they have no conflicts of interest.
Contributors
K.G. conceived, designed and supervised the study, undertook the statistical analyses and wrote the paper. D.C. served as trial and data manager for the study, undertook some data extraction for the paper and edited the paper.
Acknowledgements
The authors wish to thank Alison Parsons for her assistance in data collection and Professor Helen Christensen for feedback on the draft version of the information needs scale.
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