Impact of socioeconomic position and distance on mental health care utilization: a nationwide Danish follow-up study

Research output: Contribution to journalArticle


Purpose: To determine the impact of socioeconomic position (SEP) and distance to provider on outpatient mental health care utilization among incident users of antidepressants. Method: A nationwide register-based cohort study of 50,374 person-years. Results: Persons in low SEP were more likely to have outpatient psychiatrist contacts [odds ratio (OR) 1.25; confidence interval (CI) 1.17–1.34], but less likely to consult a co-payed psychologist (OR 0.49; CI 0.46–0.53) and to get mental health service from a GP (MHS-GP) (OR 0.81; CI 0.77–0.86) compared to persons in high SEP after adjusting for socio-demographics, comorbidity and car ownership. Furthermore, persons in low SEP who had contact to any of these therapists tended to have lower rates of visits compared to those in high SEP. When distance to services increased by 5 km, the rate of visits to outpatient psychiatrist tended to decrease by 5% in the lowest income group (IRR 0.95; CI 0.94–0.95) and 1% in the highest (IRR 0.99; CI 0.99–1.00). Likewise, contact to psychologists decreased by 11% in the lowest income group (IRR 0.89; CI 0.85–0.94), whereas rate of visits did not interact. Conclusion: Patients in low SEP have relatively lower utilization of mental health services even when services are free at delivery; co-payment and distance to provider aggravate the disparities in utilization between patients in high SEP and patients in low SEP.


  • Aake Packness
  • Frans Boch Waldorff
  • René De Pont Christensen
  • Lene Halling Hastrup
  • Erik B. Simonsen
  • Mogens Vestergaard
  • Anders Halling
External organisations
  • University of Southern Denmark
  • University of Copenhagen
  • Aarhus University
  • Region Sjælland
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology


  • Access to health care, Antidepressants, Geographic information system, Mental health services, Socioeconomic factors
Original languageEnglish
Pages (from-to)1405-1413
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number11
Early online date2017 Aug 28
Publication statusPublished - 2017
Publication categoryResearch