U.S. has high rate of mental illness, low rate of treatment

August 1, 2003

Pharmaceutical Representative

The United States has a high prevalence and low treatment rate of serious mental illness, according to a study published in the journal Health Affairs.

The United States has a high prevalence and low treatment rate of serious mental illness, according to a study published in the journal Health Affairs (vol. 22, no. 3). The study analyzed data from community surveys with more than 22,000 respondents in Canada, Chile, Germany, the Netherlands and the United States, and used the Composite International Diagnostic Interview developed in 1990 by the World Health Organization to assess mental illness.

Despite differences in treatment rates, researchers found that remarkably similar, high proportions of the populations had mental disorders (17% to 29%), with early age of onset (mostly in childhood through the early adult years), chronic mental illness, and adverse effects on jobs, marriages, and other aspects of life.

People with more serious disorders were more likely to receive treatment, but between one-third and two-thirds of people with serious disorders in the five countries reported receiving no treatment. No matter how mild or serious the mental disorder, people were more likely to receive treatment if they were older (except in Chile), educated and female.

"The consistency of these patterns across a wide variety of countries is striking," said corresponding author Ronald Kessler, professor at Harvard Medical School's department of healthcare policy. "Issue number one is that we can't wait as long as we do to get young people into treatment. Issue number two is that we have to do a better job of making sure patients are treated with the best available therapies once we manage to get them into treatment."

Undertreated population

According to Kessler, he and his co-authors were also struck by the inadequate treatments in the United States. "This involves both medical care that fails to conform with accepted treatment guidelines," Kessler said, "or care in some other sector of the treatment system, such as self-help or religious counseling, that has not been shown to be effective in treatment of clinically significant mental disorders." PR

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