Sociodemographic and Mental Health Predictors of Mental Health Service Use Across Provider Types
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Objective
To examine trends in mental health service use across four provider types (family doctors, psychiatrists, psychologists, and social workers) and identify sociodemographic predictors of provider-specific access in Canada
Methods
This study used data from seven cycles (2007–2020) of the Canadian Community Health Survey (CCHS), a nationally representative cross-sectional survey. Trends over time were examined using weighted proportions and counts of service users. Multivariable logistic regression models were conducted on the 2019–2020 cycle to assess associations between sociodemographic factors and provider-specific service use. Analyses were weighted and adjusted for sex, age, income, education, visible minority status, immigrant status, Aboriginal identity, and self-perceived health.
Results
Family doctors were consistently the most accessed providers for mental health concerns, followed by psychologists and social workers, with psychiatrists being least accessed. Psychologist and social worker use increased between 2017 and 2019. In regression models, women had significantly higher odds of using family doctors and social workers, while older adults had greater odds of accessing family doctors and lower odds of accessing psychologists and social workers. Higher education was associated with increased psychologist use, whereas lower income and education were linked to family doctor and social work use. Non-Indigenous individuals had higher odds of seeing a psychologist, and those not identifying as a visible minority had higher odds of seeing a family doctor. Poorer perceived mental health was a strong predictor of accessing all provider types.
Conclusions
This study reveals a stratified mental health care system in Canada, where sociodemographic factors shape who accesses which providers. While primary care dominates, growth in psychologist and social worker use suggests shifting patterns of engagement. Findings underscore the need for policies that address financial and structural barriers, promote equitable access, and expand coverage for community-based mental health providers.
