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The treatment gap for mental disorders remains a challenge worldwide. Identifying reasons for nontreatment may contribute to reducing this gap. To evaluate sociodemographic and clinical factors associated with use and barriers to treatment in Portugal. Data from the 2009 National Mental Health Survey were used. Participants reported 12-month treatment and reasons for nontreatment. Logistic regression models analysed the association between sociodemographic (education; employment; income; marital status) and clinical variables (mental disorder diagnosis; disability) with treatment and type of barriers (low perceived need; structural; attitudinal). The majority of participants with a mental disorder was not treated. Treatment was more common among participants with mood disorders (OR = 4.19; 95% CI: 2.72–6.46), and disability (OR = 2.43; 95% CI: 1.33–4.46), and less common among single participants (OR = 0.38; 95% CI: 0.20–0.70) and those with basic/secondary education (OR = 0.42; 95% CI: 0.24–0.73). Attitudinal barriers were more likely among participants with none/primary (OR = 2.90; 95% CI: 1.42–5.90) and basic/secondary education (OR = 1.70; 95% CI: 1.01–2.85), and less likely among those with substance use disorders (OR = 0.27; 95% CI: 0.10–0.70). Low perceived need was higher among single people (OR = 1.77; 95% CI: 1.01–3.08), and lower among those with anxiety (OR = 0.50; 95% CI: 0.28–0.90) and mood disorders (OR = 0.16; 95% CI: 0.09–0.30). Unemployed participants had higher odds of reporting structural barriers (OR = 3.76; 95% CI: 1.29–10.92). This study identifies factors associated with nontreatment, providing useful evidence to develop policies and effective interventions.

Barriers to mental health services utilisation in Portugal – results from the National Mental Health Survey