In Brief

People who feel they are having mental health problems today are far more likely to turn to nonmedical personnel--psychologists, counselors and social workers--than 20 or 40 years ago, according to an Indiana University study. In addition, of those people who at some point felt they might be having a "nervous breakdown," the research showed the proportion who sought out a psychologist, counselor or social worker rose from 0.6 percent to 18 percent between 1957 and 1996.

In contrast to the growing use of nonmedical professionals, the proportion of people with mental health problems who saw a medical doctor fell from 44 percent to 18 percent--a finding the authors cite as a surprise.

"With the rise of new medications and new medical care reimbursement policies," the authors note, "we expected more Americans to have consulted a primary-care physician for medication or to have used this as an entry point to obtain reimbursable mental health specialty care."

The study, led by psychologist Ralph Swindle Jr., PhD, looked at data from the 1957 and 1976 "Americans View Their Mental Health" surveys by the University of Michigan's Institute of Social Research and the 1996 "General Social Survey" by the National Opinion Research Center of the University of Chicago. The 1996 survey replicated some questions from the earlier studies, such as whether the respondents had ever thought they were having a nervous breakdown and what they did about it.

In 1957, 0 percent of survey participants saw a psychiatrist out of 2,460 people. That number rose to 8 percent in 1976, but fell to 3.6 percent in 1996.

The researchers also found that, over those four decades, significantly more Americans reported feeling an impending nervous breakdown: In 1957, 19 percent said they had felt that way, but in 1976 it was 21 percent, and in 1996, 26 percent. The authors suspect the change is due to a public attitude that is more accepting of psychological problems.

"Americans appear to be more willing to admit to having feelings of an impending nervous breakdown than they were 40 years ago," say the researchers.

Possibly supporting that suspicion is a growing willingness to ask family and friends for help. The number of people turning to that kind of informal support rose from 7 percent to 12 percent and then to 28 percent.

The authors note, however, "it is possible that the number of persons with diagnosable mental disorders has also been increasing."

The study, "Responses to Nervous Breakdowns in America Over a 40-year Period," appeared in the American Psychologist (Vol. 55, No. 7).