Emotional and cognitive difficulties, help-seeking, and barriers to treatment in neurological disorders

Milena Gandy*, Eyal Karin, Vincent J. Fogliati, Susanne Meares, Olav Nielssen, Nickolai Titov, Blake F. Dear

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    18 Citations (Scopus)


    Purpose/Objective: To (a) explore the mental health and wellbeing of Australian adults with neurological disorders, (b) examine their history of help-seeking behavior and perceived barriers to treatment for emotional and cognitive difficulties, and (c) assess their interest in online self-management programs. Method/Design: A sample of 2,254 (mean age = 46.3 year; SD = 14.1; 80% were female), Australians with a neurological disorder completed an online survey of standardized measures of mental health and wellbeing, and questions about help-seeking and perceived barriers to treatment. Results: There was consistent evidence of poor mental health and wellbeing across measures of psychological distress (Kessler 10, K10; M [24.6]; SD [8.6]), depression (Neurological Depressive Disorders Inventory-Epilepsy, NDDI-E; M [15.6]; SD [4.3]), disability (World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0;M[16.3]; SD [10.2]), Satisfaction With Life Scale (SWLS;M[20.0]; SD [8.0]), and perceived cognitive deficits (Perceived Cognitive Questionnaires, PDQ) in attention/concentration (M [2.1]; SD [1.2]); retrospective memory (M [2.0]; SD [1.0]); prospective memory (M [1.7]; SD [.9]); and planning/ organization (M[2.0]; SD [1.0]). Participants reported using both formal (e.g., advice from GP and neurologist) and informal help-seeking (e.g., searching the Internet) for both emotional symptoms and cognitive difficulties, but most (>70%) reported unmet needs and experiencing barriers to seeking care, including the lack of available services and beliefs that symptoms could not change. Conclusions/Implications: We found high levels of comorbid psychological distress among people with neurological disorders, widespread barriers to receiving care, and a high level of interest in an online self-management program that might help overcome barriers to accessing psychological treatment for mood symptoms and impaired cognitive function.

    Original languageEnglish
    Pages (from-to)563-574
    Number of pages12
    JournalRehabilitation Psychology
    Issue number4
    Publication statusPublished - Nov 2018


    • barriers
    • online
    • cognitive rehabilitation
    • psychological distress
    • quality of life


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