Attitudinal and Accessibility Barriers Predict Unmet Mental Health Care Needs in Distressed Cancer Patients and...

Distress affects about one-third of people with cancer, yet many never want, seek, or receive mental health care. Identifying the barriers that distinguish those who obtain help from those who do not can guide service design in psychosocial oncology.

To examine how attitudinal, stigma, instrumental, financial, and accessibility barriers predict mental-health care need status (met need, unmet need, or low perceived need or reluctance).

Survey data from 300 distressed adults in the Cancer Support Community's Cancer Experience Registry (August 2022) were analyzed. Need status reflected desire for, attempts to access, and receipt of mental health care. Multinomial logistic regression tested barrier-domain associations with need status, adjusting for sociodemographic and clinical variables.

Thirty-eight percent reported met need, 25% unmet need, and 37% low perceived need or reluctance. Each one-point increase in attitudinal barrier scores was associated with a higher likelihood of reporting unmet need (relative risk ratio [RRR] = 4.21, 95% CI 1.56-11.37) and low perceived need or reluctance (RRR = 2.85, 95% CI 1.17-6.91) compared to met need. Greater accessibility barriers were also linked to a higher likelihood of unmet need (RRR = 1.73, 95% CI 1.11-2.67). Stigma, instrumental, and financial barriers were not independent predictors in multivariate analyses.

In oncology, help-seeking and access to mental health care appear negatively associated with patient attitudinal beliefs and system-level constraints. Interventions that normalize mental health care, provide education on its benefits, and embed providers within oncology services may reduce the distress burden more effectively than strategies focusing solely on cost or logistics.