Educational level and the use of mental health services, psychotropic medication and psychotherapy in a population-based sample of Finnish adults

Mental disorders are common yet undertreated, causing difficulties in daily tasks, work disability and suffering. The amount of people in need of mental health care who are not receiving any treatment is described with the mental health treatment gap, which is considerably large across the world. Several possible factors contributing to the mental health treatment gap have been identified, including socioeconomic status. This study’s objective was to examine if educational level as an indicator of socioeconomic status is associated with mental health service use in Finland. The associations between educational level and the use of mental health services, psychotropic medication and psychotherapy were examined using data from a longitudinal, population-based cohort study. The sample used in this study consisted of 3053 men and women aged 24-68, who had reported a current or previous physician diagnosed mental disorder. The prevalence of mental disorders, the utilization of different mental health services, and educational level were assessed with self-report questionnaire. Educational level was determined by the highest self-reported educational attainment and grouped into three categories: high, intermediate, and low educational level. The associations between educational level and mental health service -related outcomes were assessed with binary logistic regression. Covariates included in the fully adjusted model were age, gender and number of somatic diseases. Low educational level, as an indicator of socioeconomic status, was associated with all mental health service -related outcomes but psychotherapy after controlling for confounding factors. Compared to high educational level, low educational level was associated with higher odds of using psychotropic medications and lower odds of using mental health services. These results are in line with previous studies suggesting a link between indicators of socioeconomic status and mental health service use. However, more research into the topic is needed to provide more detailed information and to examine possible causal connections