Abstract
Background:
Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored that perceived need is a powerful predictor of seeking treatment for mental disorders. However, little research has focused on contact coverage net of perceived need. We analysed data from the WMH surveys, investigating patterns and predictors of 12-month treatment of mental disorders in those with and without perceived need for treatment.
Methods: WMH data come from face-to-face interviews administered in 25 community surveys across 21 countries to a combined sample of n=117,739 respondents ages 18 and older. n=12,508 respondents met criteria for one or more core 12-month DSM-IV anxiety, mood, or substance use disorders. Information was obtained about 12-month treatment of each disorder. The predictors considered were disorder type, perceived need for treatment, socio-demographics, and history of prior treatment.
Results:
Treatment was obtained for 17.7% of the n=18,702 12-month person-disorders in the sample, including 34.1% for the 46.5% with perceived need and 3.5% for the 54.5% without perceived need. Net of perceived need, contact coverage was most strongly associated with disorder type (highest for generalized anxiety, panic/agoraphobia, and major depressive disorders; lowest for substance use disorders), number of disorders and severity; with health insurance, student status, and being disabled/unemployed; and with several aspects, most notably perceived helpfulness, of prior treatment. These associations were largely similar in the subsamples of cases with and without perceived need for treatment. Associations involving prior treatment differed significantly, but prevalence of 12-month treatment among cases characterized by no perceived need for treatment and no history of prior treatment and no perceived need for 12-month treatment.
Conclusions: The findings here build on prior WMH survey data showing that perceived need is crucially important for 12-month treatment, with treatment occurring only uncommonly in the absence of perceived need. In the presence of perceived need, probability of treatment varies significantly as a joint function of disorder type-severity, socio-demographic characteristics, including health insurance, and history of prior treatment. It is likely that further insights into these associations would be obtained by examining mediating effects through respondent reported barriers to treatment.
Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored that perceived need is a powerful predictor of seeking treatment for mental disorders. However, little research has focused on contact coverage net of perceived need. We analysed data from the WMH surveys, investigating patterns and predictors of 12-month treatment of mental disorders in those with and without perceived need for treatment.
Methods: WMH data come from face-to-face interviews administered in 25 community surveys across 21 countries to a combined sample of n=117,739 respondents ages 18 and older. n=12,508 respondents met criteria for one or more core 12-month DSM-IV anxiety, mood, or substance use disorders. Information was obtained about 12-month treatment of each disorder. The predictors considered were disorder type, perceived need for treatment, socio-demographics, and history of prior treatment.
Results:
Treatment was obtained for 17.7% of the n=18,702 12-month person-disorders in the sample, including 34.1% for the 46.5% with perceived need and 3.5% for the 54.5% without perceived need. Net of perceived need, contact coverage was most strongly associated with disorder type (highest for generalized anxiety, panic/agoraphobia, and major depressive disorders; lowest for substance use disorders), number of disorders and severity; with health insurance, student status, and being disabled/unemployed; and with several aspects, most notably perceived helpfulness, of prior treatment. These associations were largely similar in the subsamples of cases with and without perceived need for treatment. Associations involving prior treatment differed significantly, but prevalence of 12-month treatment among cases characterized by no perceived need for treatment and no history of prior treatment and no perceived need for 12-month treatment.
Conclusions: The findings here build on prior WMH survey data showing that perceived need is crucially important for 12-month treatment, with treatment occurring only uncommonly in the absence of perceived need. In the presence of perceived need, probability of treatment varies significantly as a joint function of disorder type-severity, socio-demographic characteristics, including health insurance, and history of prior treatment. It is likely that further insights into these associations would be obtained by examining mediating effects through respondent reported barriers to treatment.
| Original language | English |
|---|---|
| Journal | International Journal of Mental Health Systems |
| Publication status | Accepted/In press - 10 Jan 2025 |
Keywords
- mental disorders
- mental health treatment
- perceived need for treatment
