scholarly journals Barriers to mental health treatment: results from the WHO World Mental Health surveys

2013 ◽  
Vol 44 (6) ◽  
pp. 1303-1317 ◽  
Author(s):  
L. H. Andrade ◽  
J. Alonso ◽  
Z. Mneimneh ◽  
J. E. Wells ◽  
A. Al-Hamzawi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Treatment ◽  
Common Mental Disorders ◽  
Structural Barriers ◽  
Health Treatment ◽  
Need For Treatment ◽  
Attitudinal Barriers ◽  
Perceived Need ◽  
World Mental Health

BackgroundTo examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.MethodData were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 636 78) and analyzed at different levels of clinical severity.ResultsAmong those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).ConclusionsLow perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.

scholarly journals Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey

2015 ◽  
Vol 25 (3) ◽  
pp. 217-229 ◽  
Author(s):  
H. Ishikawa ◽  
N. Kawakami ◽  
R. C. Kessler ◽  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Unmet Need ◽  
Diagnostic Interview ◽  
Need For Treatment ◽  
World Mental Health ◽  
The World ◽  
Dsm Iv

Background.The aim of this study is to estimate the lifetime and 12-month prevalence, severity and treatment of Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) mental disorders in Japan based on the final data set of the World Mental Health Japan Survey conducted in 2002–2006.Methods.Face-to-face household interviews of 4130 respondents who were randomly selected from Japanese-speaking residents aged 20 years or older were conducted from 2002 to 2006 in 11 community populations in Japan (overall response rate, 56%). The World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay administered psychiatric diagnostic interview, was used for diagnostic assessment.Results.Lifetime/12-month prevalence of any DSM-IV common mental disorders in Japan was estimated to be 20.3/7.6%. Rank-order of four classes of mental disorders was anxiety disorders (8.1/4.9%), substance disorders (7.4/1.0%), mood disorders (6.5/2.3%) and impulse control disorders (2.0/0.7%). The most common individual disorders were alcohol abuse/dependence (7.3/0.9%), major depressive disorder (6.1/2.2%), specific phobia (3.4/2.3%) and generalized anxiety disorder (2.6/1.3%). While the lifetime prevalence of any mental disorder was greater for males and the middle-aged, the persistence (proportion of 12-month cases among lifetime cases) of any mental disorder was greater for females and younger respondents. Among those with any 12-month disorder, 15.3% were classified as severe, 44.1% moderate and 40.6% mild. Although a strong association between severity and service use was found, only 21.9% of respondents with any 12-month disorder sought treatment within the last 12 months; only 37.0% of severe cases received medical care. The mental health specialty sector was the most common resource used in Japan. Although the prevalence of mental disorders were quite low, mental disorders were the second most prevalent cause of severe role impairment among chronic physical and mental disorders.Conclusions.These results suggest lower prevalence of mental disorders in Japan than that in Western countries, although the general pattern of disorders, risk factors and unmet need for treatment were similar to those in other countries. Greater lifetime prevalence for males and greater persistence for females seems a unique feature of Japan, suggesting a cultural difference in gender-related etiology and course of disorders. The treatment rate in Japan was lower than that in most other high-income countries in WMH surveys.

scholarly journals Barriers to mental health treatment: results from the National Comorbidity Survey Replication

2010 ◽  
Vol 41 (8) ◽  
pp. 1751-1761 ◽  
Author(s):  
R. Mojtabai ◽  
M. Olfson ◽  
N. A. Sampson ◽  
R. Jin ◽  
B. Druss ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Health Treatment ◽  
Common Mental Disorders ◽  
Drop Out ◽  
Common Reason ◽  
Treatment Seeking ◽  
Structural Barriers ◽  
National Comorbidity Survey Replication ◽  
Perceived Need ◽  
National Comorbidity Survey

BackgroundThe aim was to examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the US general population.MethodRespondents in the National Comorbidity Survey Replication with common 12-month DSM-IV mood, anxiety, substance, impulse control and childhood disorders were asked about perceived need for treatment, structural barriers and attitudinal/evaluative barriers to initiation and continuation of treatment.ResultsLow perceived need was reported by 44.8% of respondents with a disorder who did not seek treatment. Desire to handle the problem on one's own was the most common reason among respondents with perceived need both for not seeking treatment (72.6%) and for dropping out of treatment (42.2%). Attitudinal/evaluative factors were much more important than structural barriers both to initiating (97.4% v. 22.2%) and to continuing (81.9% v. 31.8%) of treatment. Reasons for not seeking treatment varied with illness severity. Low perceived need was a more common reason for not seeking treatment among individuals with mild (57.0%) than moderate (39.3%) or severe (25.9%) disorders, whereas structural and attitudinal/evaluative barriers were more common among respondents with more severe conditions.ConclusionsLow perceived need and attitudinal/evaluative barriers are the major barriers to treatment seeking and staying in treatment among individuals with common mental disorders. Efforts to increase treatment seeking and reduce treatment drop-out need to take these barriers into consideration as well as to recognize that barriers differ as a function of sociodemographic and clinical characteristics.

scholarly journals The Relation between Perceived Need for Mental Health Treatment, DSM Diagnosis, and Quality of Life: A Canadian Population-Based Survey

2005 ◽  
Vol 50 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Jitender Sareen ◽  
Murray B Stein ◽  
Darren W Campbell ◽  
Thomas Hassard ◽  
Verena Menec
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Treatment ◽  
Population Based ◽  
Health Treatment ◽  
Need For Treatment ◽  
Perceived Need ◽  
Perceived Need For Treatment

Objectives: Prevalence estimates of mental disorders were designed to provide an indirect estimate of the need for mental health services in the community. However, recent studies have demonstrated that meeting criteria for a DSM-based disorder does not necessarily equate with need for treatment. The current investigation examined the relation between self-perceived need for mental health treatment and DSM diagnosis, with respect to quality of life (QoL) and suicidal ideation. Methods: Data came from an Ontario population-based sample of 8116 residents (aged 15 to 64 years). The University of Michigan Composite International Diagnostic Interview was used to diagnose mood, anxiety, substance use, and bulimia disorder according to DSM-III-R criteria. We categorized past-year help seeking for emotional symptoms and (or) perceiving a need for treatment without seeking care as self-perceived need for treatment. We used a range of variables to measure QoL: self-perception of mental health status, a validated instrument that measured well-being, and restriction of activities (current, past 30 days, and long-term). Results: Independent of subjects' meeting criteria for a DSM-III-R diagnosis, self-perceived need for treatment was significantly associated with poor QoL (on all measures) and past-year suicidal ideation. Conclusions: Self-perceived need for mental health treatment, in addition to DSM diagnosis, may provide valuable information for estimating the number of people in the population who need mental health services. The relation between self-perceived need for treatment and objective measures of treatment need requires future study.

scholarly journals Barriers to Mental Health Treatment in the Saudi National Mental Health Survey

2020 ◽  
Vol 17 (11) ◽  
pp. 3877 ◽  
Author(s):  
Abdulaziz S. Alangari ◽  
Sarah S. Knox ◽  
Alfgeir L. Kristjansson ◽  
Sijin Wen ◽  
Kim E. Innes ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Survey ◽  
Mental Health Treatment ◽  
Service Use ◽  
World Health ◽  
Health Treatment ◽  
Attitudinal Barriers ◽  
Perceived Need ◽  
Mental Health Survey ◽  
National Mental Health

Objectives: To examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the Saudi National Mental Health Survey (SNMHS). Methods: The SNMHS is a community-based epidemiological survey in a nationally representative household sample of respondents aged 15–65 in the Kingdom of Saudi Arabia. The World Health Organization Composite International Diagnostic Interview (CIDI) 3.0 was used. Predictors of barriers to treatment were analyzed with multivariable logistic regression. Results: Among participants with a 12-month DSM-IV/CIDI disorder (n = 711), 86.1% reported no service use. Of those (n = 597), 50.7% did not think they needed any help (categorized as “low perceived need”) and 49.3% did perceive need. Of those who perceived need (n = 309), the majority (98.9%) reported attitudinal barriers to initiation. In contrast, 10.3% of those with a perceived need reported structural barriers. Respondents who were previously married or indicated below-average income were more likely to believe they needed help. Conclusions: Among people with a diagnosed mental disorder, low perceived need and attitudinal barriers are the primary barriers to mental health treatment in the KSA. The results suggest that addressing poor mental health literacy may be essential factor in reducing the unmet need for mental health treatment in the KSA.

The WHO World Mental Health (WMH) Surveys

2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Treatment Effectiveness ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Mental Health Policy ◽  
Unmet Need ◽  
Cost Effective ◽  
World Mental Health ◽  
Prevalence Estimates

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

Suicidality and Treatment Experience Among Young People Who Inject Drugs

2020 ◽  
Author(s):  
Mary Ellen Mackesy-Amiti ◽  
Lawrence J. Ouellet
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Treatment ◽  
People Who Inject Drugs ◽  
Multivariable Analysis ◽  
Psychiatric Research ◽  
Health Treatment ◽  
The Past

Background. We examined correlates of past year suicidal thoughts and behavior (STB) and described past year treatment experiences among young people who inject drugs (PWID). Methods. Participants were 570 adults (18-25 years) who injected primarily heroin. Interviews were conducted at field stations operated by Community Outreach Intervention Projects in Chicago, Illinois (USA). Interviewers administered the Psychiatric Research Instrument for Substance and Mental Disorders. Substance use and mental disorders were based on DSM-IV diagnostic criteria. Past year STB was based on multiple questions. Results. Sixteen percent of men and 25% of women reported STB in the past year. In multivariable analysis, STB was associated with non-heterosexual orientation, foster care, and being raised by two parents. Primary major depression, post-traumatic stress disorder, other anxiety disorders, and borderline personality disorder had independent effects on suicidality. Among those reporting past year STB (n=111), 83% ever received mental health treatment, while 44% did so in the past year. While 24% of respondents indicated that at least one treatment matched their needs very well, 30% reported treatment that did not match their needs at all. The most common reason for ending treatment was program completion (about 50%) while getting better was endorsed by about 25%. Nearly half reported ending treatment due to a bad experience, logistical issues, or expense. Conclusions. Young PWID are at high risk for suicidal behavior and their mental health treatment experiences often do not meet their needs. There is a pressing need for more integrated substance use and mental health treatment.

scholarly journals Mental health of young Brazilians: Barriers to professional help-seeking

2016 ◽  
Vol 33 (2) ◽  
pp. 355-365 ◽  
Author(s):  
Cláudia Cristina FUKUDA ◽  
Maria Aparecida PENSO ◽  
Deise Matos do AMPARO ◽  
Bruno Coimbras de ALMEIDA ◽  
Camila de Aquino MORAIS
Keyword(s):  
Mental Health ◽  
Young People ◽  
Private School ◽  
Mental Health Treatment ◽  
Help Seeking ◽  
Structural Barriers ◽  
Professional Help ◽  
Health Treatment ◽  
Major Barrier ◽  
Positive Effects

The present study investigated the perception of young Brazilians of professional help and barriers to seeking mental health services. A total of the 1,030 questionnaires were administered to young people aged 8-21 years of both genders attending public and private school or who had received or were receiving treatement at mental health facilities in three Brazilian cities. The data were evaluated using descriptive statistics, exploratory factor analysis, and comparison between means. The results showed fear of stigmatization as a major barrier to seeking mental health treatment, exerting greater impact than that of structural barriers. Regional differences influenced their perception of the treatment. Having undergone previous mental health treatment was found to be related to a greater perception of the positive effects of the treatment and the structural barriers to accessing care services. It was found that the onset of mental disorders usually occurs during early adolescence. School-related issues, anxiety, fear, and depression were the most common reasons for mental health treatment seeking among young people.

scholarly journals Feasibility and Conceptualization of an e-Mental Health Treatment for Depression in Older Adults: Mixed-Methods Study (Preprint)

2018 ◽  
Author(s):  
Christiane Eichenberg ◽  
Markus Schott ◽  
Adam Sawyer ◽  
Georg Aumayr ◽  
Manuela Plößnig
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Focus Groups ◽  
Mental Health Treatment ◽  
Common Mental Disorders ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Health Treatment ◽  
Web Based ◽  
The Everyday

BACKGROUND Depression is one of the most common mental disorders in older adults. Unfortunately, it often goes unrecognized in the older population. OBJECTIVE The aim of this study was to identify how Web-based apps can recognize and help treat depression in older adults. METHODS Focus groups were conducted with mental health care experts. A Web-based survey of 56 older adults suffering from depression was conducted. Qualitative interviews were conducted with 2 individuals. RESULTS Results of the focus groups highlighted that there is a need for a collaborative care platform for depression in old age. Findings from the Web-based study showed that younger participants (aged 50 to 64 years) used electronic media more often than older participants (aged 65 years and older). The interviews pointed in a comparable direction. CONCLUSIONS Overall, an e-mental (electronic mental) health treatment for depression in older adults would be well accepted. Web-based care platforms should be developed, evaluated, and in case of evidence for their effectiveness, integrated into the everyday clinic.

JS03-03 - Prevalence and Impact of Common Mental Disorders: International Similarities & Differences. Results of the Who World Mental Health (WMH) Surveys Initiative

2011 ◽  
Vol 26 (S2) ◽  
pp. 2005-2005
Author(s):  
J. Alonso ◽  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Disruptive Behaviour ◽  
International Variation ◽  
Reporting Practices ◽  
World Mental Health ◽  
Substance Disorders ◽  
Prevalence Estimates ◽  
Role Impairment

Introduction A number of studies have shown that there is international variation in the prevalence of common mental disorders. Several factors have been suggested to explain such differences. Methodological challenges to comparability include: differences in settings, samples, assessment methods, and reporting practices. Also, cultural differences have been pointed out as possible cause of differential recognition and reporting of mental health issues. There is still uncertainty about the degree of international variation in the prevalence of mental disorders, and the lack of comparability of results is still an issue.Objectives We assessed the prevalence and impact of mental disorders in the WHO World Mental Health (WMH) Survey Initiative, using common survey, assessment and reporting methods.Methods The WMH surveys were completed in 24 countries from Africa, the Americas, Asia, Europe, the Middle-East and the Pacific. Representative samples of the adult, non-institutionalizes population were interviewed face-to-face, with the aim of estimating the prevalence, burden and unmet need for treatment of common mental disorders. The Composite International Diagnostic Interview (CIDI, 3.0) was used in all surveys to assess mental health status. Common mental disorders assessed included: anxiety, mood, disruptive behaviour, and substance disorders. Several standard measures of disability, both generic and disorder-specific, and role impairment were administered.Results Results show that the mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th–75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behaviour, and substance disorders) is 18.1–31.1%. The IQR of 12 month prevalence estimates is 9.8–19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4–6.8% in half of the countries, 2.3–3.6% in one-fourth and 0.8–1.9% in one-fourth. Possible causes of international variation will be addressed. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Mental disorders are found in the WMH data to be associated with high levels of role impairment.Conclusions Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective form both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several of these interventions.Additional information about the WMH Surveys Initiative and the funing of the project can be found at: http://www.hcp.med.harvard.edu/wmh/

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