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Background: Mental disorders constitute a significant public health problem worldwide. Ensuring that those who need mental health services access them in an appropriate and timely manner is thus an important public health priority. We used data from 4 cross-sectional, nationally representative population health surveys that employed nearly identical methods to compare MHSU trends in the Canadian military versus comparable civilians., Method: The surveys were all conducted by Statistics Canada, approximately a decade apart (Military-2002, Military-2013, Civilian-2002, and Civilian-2012). The sample size for the pooled data across the surveys was 35,984. Comparisons across the 4 surveys were adjusted for differences in need in the 2 populations at the 2 time points., Results: Our findings suggested that first, in the Canadian military, there was a clear and consistent pattern of improvement (i.e., increase) in MHSU over the past decade across a variety of provider types. The magnitudes of the changes were large, representing an absolute increase of 7.15% in those seeking any professional care, corresponding to an 84% relative increase. Second, in comparable Canadian civilians, MHSU remained either unchanged or increased only slightly. Third, the increases in MHSU over time were consistently greater in the military than in the comparable civilian sample., Conclusions: Our findings point to advantages with respect to MHSU of the military mental health system over the civilian system in Canada; these advantages have widened substantially over time. These findings speak strongly to the potential impact of analogous changes in other health systems, both military and civilian.

Purpose: Despite the availability of efficacious treatments, few individuals with a new-onset mental disorder access treatment in a timely manner. While barriers to mental health treatment have been studied among prevalent cases, few studies have focused specifically on incident cases. The purpose of the current study was to examine the prevalence and correlates of perceived barriers to mental health treatment among incident cases., Methods: Data came from the Canadian Community Health Survey, cycle 1.2 (CCHS 1.2), which represents a nationally representative sample of 36,984 Canadians. We used descriptive analyses to estimate the prevalence of different types of perceived barriers to treatment and logistic regression analyses to estimate the association between potential correlates and the probability of endorsing each type of barrier., Results: The most frequently reported type of barrier was acceptability. Coping efficacy and psychological well-being were negatively associated with the likelihood of reporting accessibility barriers. Education was negatively associated with reporting acceptability barriers but positively associated with reporting availability barriers., Conclusions: Among individuals with a recent disorder onset, acceptability barriers are the most frequently reported. Perceived accessibility barriers may be open to influence from current clinical functioning and current perceptions of internal coping resources. These findings contribute to an important discussion about the complexity of pathways to care and point to the need for comprehensive approaches to overcoming barriers to care.

Background: Mental disorders constitute a significant public health problem in active military populations. However, very little is known about patterns of mental health service use in these populations., Objectives: The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members. Additional objectives included identification of barriers to service use., Design: A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement., Subjects and Measures: Participants were assessed for mood, anxiety, and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Those who met criteria for at least 1 disorder in the past year (n = 1220) were included in the analyses., Results: Of military members with a 12-month diagnosis, 42.6% used services in the past year. Predictors of service use included mental health indicators, gender, marital status, and military rank. Of military members who failed to use services, only a small percentage (3.5-16.0%) acknowledged a need for services. These members perceived a number of barriers to services, foremost among which was lack of trust in military health, administrative, and social services., Conclusions: Despite recent efforts to de-stigmatize mental health problems and treatments, unmet need for mental health services remains a significant problem in active militaries. Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in health delivery systems to gain the trust of military members.