Mental Health Care Utilization and its Barriers among Iranian Breast Cancer Survivors: A Cross-sectional Study

Abstract

Background: Depression and anxiety are common comorbidities complicating the care of breastcancer patients, but many patients do not receive the needed care. We aimed to assess utilization ofmental health care and its barriers in breast cancer survivors.Methods: This cross-sectional study was conducted on 311 patients with breast cancer, in Iran,November 2021 to March 2022. Perceived need and utilization of mental health care and barriers toservice utilization were measured based on self-report. Depression, Anxiety, and Stress Scale-21 andMultidimensional Scale of Perceived Social Support were used to assess depression, anxiety, and stressas well as social support, respectively. A linear and logistic regression model was used to analyze thedata using SPSS version 22. A P-value less than 0.05 was considered statistically significant.Results: 70.1% of the participants perceived need for mental health care, 28.0% of them had used mentalhealth services, and 72% were classified as having unmet needs. The most common perceived barrierto service use was patients’ self-adequacy. The prevalence of extremely severe levels of depression,anxiety, and stress was 14.8%, 23.5%, and 10.6%. Also, 48.6%, 78.5%, and 75.6% of patients receiveda high level of social support from friends, family, and significant others.Conclusion: Findings highlight a substantial unmet need for mental health care and low utilization ofmental health services among breast cancer survivors. Given the significant prevalence of depression,anxiety, and stress in this population, it is imperative to address the underutilization of mental healthservices and to further examine the barriers preventing patients from seeking the care they require.

Keywords

• breast neoplasms
• cancer survivors
• health services accessibility
• mental health services