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TOPLINE:

Only 7% of patients with psychiatric and substance use disorders received effective treatment globally between 2001 and 2019, with major barriers including a low perceived need, a new study of 21 countries showed.

METHODOLOGY:

• World Mental Health surveys were administered to representative adult household samples in 21 countries, with data collection spanning from 2001 to 2019.
• The 12-month prevalence and treatment of nine anxiety, mood, and substance use disorders were assessed in nearly 57,000 respondents (median age, 43 years; 58% women) using the Composite International Diagnostic Interview.
• Researchers defined effective treatment at the disorder level using information about severity and published treatment guidelines regarding adequate medication type and adherence and adequate psychotherapy frequency.
• Individual-level predictors and country-level predictors were traced through intervening outcomes.

TAKEAWAY:

• The pooled 12-month prevalence of any disorder across surveys was 13.8%.
• Only 6.9% of 12-month person-disorders received effective treatment, but variations across disorders ranged from 1.4% for alcohol use disorder to 12% for generalized anxiety disorder.
• Major barriers to care included low perceived need (46.5%), low treatment contact given perceived need (34.1%), and low effective treatment given minimally adequate treatment (47%), with substantial variation for all categories across disorders.
• Country-level factors, such as higher healthcare spending and more nonpsychiatrist physicians, and individual factors, such as being a woman or middle-aged or having a higher education or insurance, increased the likelihood of effective mental health treatment.

IN PRACTICE:

“Understanding where the bottlenecks are for each of these disorders provides a unique and previously unavailable blueprint for decision makers to understand problems objectively and try to adjust the system,” lead author Daniel V. Vigo, MD, DrPH, Department of Psychiatry, University of British Columbia, Vancouver, Canada, said in a press release.

SOURCE:

The study was published online on February 5 in JAMA Psychiatry.

LIMITATIONS:

The limitations included reliance on self-reported treatment data, which may be susceptible to recall and social desirability bias, and widely ranging fieldwork dates from 2001 to 2019. Additionally, the study presented pooled data from 21 countries rather than country-specific analyses, focusing on systematic country-level dimensions of between-country differences. Findings for the nine disorders studied may also not generalize to other conditions.

DISCLOSURES:

The included surveys received support from various sources. Some of the investigators reported receiving funding from sources including the government, academia, and industry, as well as consulting fees, contracts, and stock options in healthcare and mental health sectors. Full details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.