Factors of Mental Health Service Utilization by Community-Dwelling Adults in Shanghai, China

This study investigated the utilization of Mental Health Services (MHS) and associated predisposing, enabling, and need factors among residents of Shanghai, China. It used a cross-sectional design and a structured questionnaire. We selected 3502 residents aged 18 years and older through multi-stage, stratified random sampling; trained mental health personnel interviewed them. Multivariate logistic regression analysis explored the predictors of MHS utilization. Among respondents, approximately 21.4% reported depressive symptoms, whereas only 4.7% had utilized MHS. The factors that were significantly related to MHS utilization were the predisposing factors of gender, marital status, occupation, and mental health knowledge; the enabling factors of perceived need for mental health help, regular mental health resources, and government salvage objects; and the need factors of moderate and severe depressive symptoms. Underutilization of MHS in Shanghai is pervasive and worrisome. Interventions in the culture and environment to improve public mental health knowledge are crucial.