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

LH Andrade, J Alonso, Z Mneimneh, JE Wells, A Al-Hamzawi, G Borges, E Bromet, R Bruffaerts, G de Girolamo, R de Graaf, S Florescu, O Gureje, HR Hinkov, C Hu, Y Huang, I Hwang, R Jin, EG Karam, V Kovess-Masfety, D Levinson & 11 others H Matschinger, Siobhan O'Neill, J Posada-Villa, R Sagar, NA Sampson, C Sasu, DJ Stein, T Takeshima, MC Viana, M Xavier, RC Kessler

Research output: Contribution to journalArticle

246 Citations (Scopus)

Abstract

Background
To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.

Method
Data 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.

Results
Among 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).

Conclusions
Low 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.

LanguageEnglish
Pages1303-1317
JournalPsychological Medicine
Volume44
Issue number6
Early online date9 Aug 2013
DOIs
Publication statusPublished - 30 Apr 2014

Fingerprint

Health Surveys
Mental Health
Therapeutics
Mental Disorders
Global Health
Health Literacy
Diagnostic and Statistical Manual of Mental Disorders

Keywords

  • Continuity
  • mental health care
  • treatment seeking

Cite this

Andrade, LH., Alonso, J., Mneimneh, Z., Wells, JE., Al-Hamzawi, A., Borges, G., ... Kessler, RC. (2014). Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological Medicine, 44(6), 1303-1317. https://doi.org/10.1017/S0033291713001943
Andrade, LH ; Alonso, J ; Mneimneh, Z ; Wells, JE ; Al-Hamzawi, A ; Borges, G ; Bromet, E ; Bruffaerts, R ; de Girolamo, G ; de Graaf, R ; Florescu, S ; Gureje, O ; Hinkov, HR ; Hu, C ; Huang, Y ; Hwang, I ; Jin, R ; Karam, EG ; Kovess-Masfety, V ; Levinson, D ; Matschinger, H ; O'Neill, Siobhan ; Posada-Villa, J ; Sagar, R ; Sampson, NA ; Sasu, C ; Stein, DJ ; Takeshima, T ; Viana, MC ; Xavier, M ; Kessler, RC. / Barriers to mental health treatment: results from the WHO World Mental Health surveys. In: Psychological Medicine. 2014 ; Vol. 44, No. 6. pp. 1303-1317.
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abstract = "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.",
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Andrade, LH, Alonso, J, Mneimneh, Z, Wells, JE, Al-Hamzawi, A, Borges, G, Bromet, E, Bruffaerts, R, de Girolamo, G, de Graaf, R, Florescu, S, Gureje, O, Hinkov, HR, Hu, C, Huang, Y, Hwang, I, Jin, R, Karam, EG, Kovess-Masfety, V, Levinson, D, Matschinger, H, O'Neill, S, Posada-Villa, J, Sagar, R, Sampson, NA, Sasu, C, Stein, DJ, Takeshima, T, Viana, MC, Xavier, M & Kessler, RC 2014, 'Barriers to mental health treatment: results from the WHO World Mental Health surveys', Psychological Medicine, vol. 44, no. 6, pp. 1303-1317. https://doi.org/10.1017/S0033291713001943

Barriers to mental health treatment: results from the WHO World Mental Health surveys. / Andrade, LH; Alonso, J; Mneimneh, Z; Wells, JE; Al-Hamzawi, A; Borges, G; Bromet, E; Bruffaerts, R; de Girolamo, G; de Graaf, R; Florescu, S; Gureje, O; Hinkov, HR; Hu, C; Huang, Y; Hwang, I; Jin, R; Karam, EG; Kovess-Masfety, V; Levinson, D; Matschinger, H; O'Neill, Siobhan; Posada-Villa, J; Sagar, R; Sampson, NA; Sasu, C; Stein, DJ; Takeshima, T; Viana, MC; Xavier, M; Kessler, RC.

In: Psychological Medicine, Vol. 44, No. 6, 30.04.2014, p. 1303-1317.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Barriers to mental health treatment: results from the WHO World Mental Health surveys

AU - Andrade, LH

AU - Alonso, J

AU - Mneimneh, Z

AU - Wells, JE

AU - Al-Hamzawi, A

AU - Borges, G

AU - Bromet, E

AU - Bruffaerts, R

AU - de Girolamo, G

AU - de Graaf, R

AU - Florescu, S

AU - Gureje, O

AU - Hinkov, HR

AU - Hu, C

AU - Huang, Y

AU - Hwang, I

AU - Jin, R

AU - Karam, EG

AU - Kovess-Masfety, V

AU - Levinson, D

AU - Matschinger, H

AU - O'Neill, Siobhan

AU - Posada-Villa, J

AU - Sagar, R

AU - Sampson, NA

AU - Sasu, C

AU - Stein, DJ

AU - Takeshima, T

AU - Viana, MC

AU - Xavier, M

AU - Kessler, RC

PY - 2014/4/30

Y1 - 2014/4/30

N2 - 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.

AB - 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.

KW - Continuity

KW - mental health care

KW - treatment seeking

UR - https://pure.ulster.ac.uk/en/publications/barriers-to-mental-health-treatment-results-from-the-who-world-me

U2 - 10.1017/S0033291713001943

DO - 10.1017/S0033291713001943

M3 - Article

VL - 44

SP - 1303

EP - 1317

JO - Psychological Medicine

T2 - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

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Andrade LH, Alonso J, Mneimneh Z, Wells JE, Al-Hamzawi A, Borges G et al. Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological Medicine. 2014 Apr 30;44(6):1303-1317. https://doi.org/10.1017/S0033291713001943