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Can J Psychiatry. 2010 Sep;55(9):586-97.

Seeking help for mental health problems outside the conventional health care system: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD).

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  • 1Mutuelle Générale de l'Education Nationale Foundation for Public Health, Paris, France.



In certain countries, it is not uncommon to turn to professionals outside the conventional health care system for psychological problems. As this situation is not well documented in Europe, we assessed use of nonconventional care for mental health in 6 European countries.


A cross-sectional survey was conducted in representative samples of noninstitutionalized adults in 6 European countries. Participants (n = 8796) completed a survey, which included, among other items, the Composite International Diagnostic Interview 3.0 and in-depth questions about lifetime consultations for mental health problems.


Among the respondents (n = 2928) who reported having already sought help in their lifetime for psychological problems (20.0%), 8.6% turned to complementary and alternative medicine (CAM) providers, such as chiropractors and herbalists, and a similar proportion (8.4%) to religious advisers such as ministers, priests, or rabbis. Only a small proportion (2.9%) consulted only these professionals for their problems. CAM providers were more frequently used in the Netherlands (13.5%) and Germany (9.4%), while religious advisers were more often consulted in Italy (12.6%) and Germany (11.6%). Multivariate analyses confirmed differences between countries and revealed that people turning to religious advisers tended to be older, foreign born, and with alcohol problems, whereas those consulting CAM providers were younger, wealthier, and more frequently depressed.


In Europe, patients who turn to CAM therapists and those who seek help from religious advisers for psychological problems are not exactly the same. In addition, these professionals are not consulted frequently in most countries, and are almost always associated with more traditional follow-up when used.

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