Barriers to mental health treatment

Results from the WHO World Mental Health surveys

Bibliographic Data

ID23323937
AuthorsLaura Helena Andrade (0000-0002-2362-3521, Universidade de São Paulo), Jordi Alonso (0000-0001-8627-9636, Hospital Del Mar), Zeina Mneimneh (0000-0002-1091-7838, University of Michigan), J Elisabeth Wells (University of Otago), A Al-Hamzawi (University of Al-Qadisiyah), Guilherme Borges (0000-0002-8687-9452, Universidad Autónoma Metropolitana), Evelyn J Bromet (0000-0002-2648-5793, State University of New York), E Bromet, Ronny Bruffaerts (0000-0002-0330-3694, KU Leuven), Giovanni De Girolamo (0000-0002-1611-8324, Centro San Giovanni di Dio Fatebenefratelli), R DE GRAAF (Trimbos Institute), Silvia Florescu (0000-0003-4647-0721, National School of Public Health, Management and Professional Development), Oye Gureje (0000-0003-0094-5947, University of Ibadan), H R Hinkov (National Center of Public Health and Analyses), C Hu (0000-0002-6080-5594), Yueqin Huang (0000-0001-5493-5838, Peking University), I Hwang (Harvard University), R Jin (0000-0002-8542-7614, Harvard Pilgrim Health Care), E G Karam (Institute for Development, Research, Advocacy and Applied Care), Viviane Kovess-Masféty (0000-0001-7045-6175, École des Hautes Études en Santé Publique), Daphna Levinson (Israel Ministry of Health), Herbert Matschinger (0000-0001-7146-6770, Leipzig University), Siobhan O'Neill (0000-0002-8786-2118, University of Ulster), J Posada-Villa, J Posada‐Villa (Pontificia Universidad Javeriana), Rajesh Sagar (0000-0003-4563-7841, All India Institute of Medical Sciences), N A Sampson (Harvard University), Carmen Sasu (National School of Public Health, Management and Professional Development), Dan J Stein (0000-0001-7218-7810, University of Cape Town), Tadashi Takeshima (0000-0001-5200-9793, National Center of Neurology and Psychiatry), Maria Carmen Viana (0000-0002-0464-4845, Universidade Federal do Espírito Santo), Miguel Xavier (0000-0003-2698-1284, Universidade Nova de Lisboa), R C Kessler (0000-0003-4831-2305), Rc Kessler (Harvard University, corresponding author)
Year2014
Volume44
Issue6
Pages1303-1317
Publication date2014-04-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePsychological Medicine (JOURNAL)
Journal identifiersISSN: 0033-2917 • E-ISSN: 1469-8978
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0033291713001943
PMID23931656
PMCIDPMC4100460
OpenAlexW2100695323
LanguageEN
Citations received172
References cited51

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.

Environmental health · Mental health · Mental health literacy · Mental illness · Population · Psychiatry · Clinical Psychology · Digital Mental Health Interventions · Medicine · Mental Health Treatment and Access · Psychology · Treatment of Major Depression