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Population level of unmet need for mental healthcare in Europe

  • Jordi Alonso (a1), Miquel Codony (a1), Viviane Kovess (a2), Matthias C. Angermeyer (a3), Steven J. Katz (a4), Josep M. Haro (a5), Giovanni De Girolamo (a6), Ron De Graaf (a7), Koen Demyttenaere (a8), Gemma Vilagut (a1), Josué Almansa (a1), Jean Pierre Lépine (a9) and Traolach S. Brugha (a10)...

Abstract

Background

The high prevalence of mental disorders has fuelled controversy about the need for mental health services.

Aims

To estimate unmet need for mental healthcare at the population level in Europe.

Method

As part of the European Study of Epidemiology of Mental Disorders (ESEMeD) project, a cross-sectional survey was conducted of representative samples of the adult general population of Belgium, France, Germany, Italy, The Netherlands and Spain (n=8796). Mental disorders were assessed with the Composite International Diagnostic Interview 3.0. Individuals with a 12-month mental disorder that was disabling or that had led to use of services in the previous 12 months were considered in need of care.

Results

About six per cent of the sample was defined as being in need of mental healthcare. Nearly half (48%) of these participants reported no formal healthcare use. In contrast, only 8% of the people with diabetes had reported no use of services for their physical condition. In total, 3.1% of the adult population had an unmet need for mental healthcare. About 13% of visits to formal health services were made by individuals without any mental morbidity.

Conclusions

There is a high unmet need for mental care in Europe, which may not be eliminated simply by reallocating existing healthcare resources.

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Copyright

Corresponding author

Jordi Alonso, Health Services Research Unit, Institut Municipal d'Investigació Mèdica (IMIM – Hospital del Mar), Carrer del Doctor Aiguader, 88 E-08003 Barcelona, Spain. Tel: +34 93 316 0754; fax: + 34 93 316 0797; email: jalonso@imim.es

Footnotes

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Freely available online through the British Journal of Psychiatry open access option.

Declaration of interest

Partial funding from GlaxoSmithKline (see Acknowledgements).

Footnotes

References

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Alonso, J., Angermeyer, M. C., Bernert, S., et al (2004a) Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109 (suppl. 420), 820.
Alonso, J., Angermeyer, M. C., Bernert, S., et al (2004b) Use of mental health services in Europe: results from the European Study of the Epidemiology of Menta Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109 (suppl. 420), 4754.
Andersen, R. M. (1995) Revisiting the behavioral model and access to medical care: does it matter? Journal of Health and Social Behavior, 36, 1.
Andrade, L., Caraveo-Anduaga, J. J., Berglund, P., et al (2003) The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys. International Journal of Methods in Psychiatric Research, 12, 321.
Andrews, G., Henderson, S. & Hall, W. (2001a) Prevalence, comorbidity, disability and service utilisation: overview of the Australian National Mental Health Survey. British Journal of Psychiatry, 178, 145153.
Andrews, G., Issakidis, C. & Carter, G. (2001b) Shortfall in mental health service utilisation. British Journal of Psychiatry, 179, 417425.
Aoun, S., Pennebaker, D. & Wood, C. (2004) Assessing population need for mental health care: a review of approaches and predictors. Mental Health Services Research, 6, 3346.
Bebbington, P. (2000) The need for psychiatric treatment in the general population. In Unmet Need in Psychiatry, pp. 8596. Cambridge University Press.
Bijl, R. V. & Ravelli, A. (2000) Psychiatric morbidity, service use, and need for care in the general population: results of The Netherlands Mental Health Survey and Incidence Study. American Journal of Public Health, 90, 602607.
Chwastiak, L. A. & Von Korff, M. (2003) Disability in depression and back pain: evaluation of the World Health Organization Disability Assessment Schedule (WHO DAS II) in a primary care setting. Journal of Clinical Epidemiology, 56, 507514.
Clarkson, P., McCrone, P., Sutherby, K., et al (1999) Outcomes and costs of a community support worker service for the severely mentally ill. Acta Psychiatrica Scandinavica, 99, 196206.
Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., et al (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA, 291, 25812590.
Graaf, R., de Bijl, R. V., Smit, F., et al (2000) Psychiatric and sociodemographic predictors of attrition in a longitudinal study: the Netherlands Mental Health Survey and Incidence Study (NEMESIS). American Journal of Epidemiology, 152, 10391047.
Jenkins, R., Lewis, G., Bebbington, P., et al (1997) The National Psychiatric Morbidity surveys of Great Britain – initial findings from the household survey. Psychological Medicine, 27, 775789.
Kessler, R. C. & Ustun, T. B. (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13, 93121.
Kessler, R. C., Berglund, P., Demler, O., et al (2003) The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289, 30953105.
Kessler, R. C., Demler, O., Frank, R. G., et al (2005) Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine, 352, 25152523.
Lin, E., Goering, P., Offord, D. R., et al (1996) The use of mental health services in Ontario: epidemiologic findings. Canadian Journal of Psychiatry, 41, 572577.
McConnell, P., Bebbington, P., McClelland, R., et al (2002) Prevalence of psychiatric disorder and the need for psychiatric care in Northern Ireland: population study in the District of Derry. British Journal of Psychiatry, 181, 214219.
Mechanic, D. (2003) Is the prevalence of mental disorders a good measure of the need for services? Health Affairs, 22, 820.
Mojtabai, R., Olfson, M. & Mechanic, D. (2002) Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Archives of General Psychiatry, 59, 7784.
Narrow, W. E., Rae, D. S., Robins, L. N., et al (2002) Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys' estimates. Archives of General Psychiatry, 59, 115123.
Pincus, H. A., Davis, W. W. & McQueen, L. E. (1999) ‘Subthreshold’ mental disorders. A review and synthesis of studies on minor depression and other ‘brand names’. British Journal of Psychiatry, 174, 288296,.
Regier, D. A., Narrow, W. E., Rae, D. S., et al (1993) The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry, 50, 8594.
Rhodes, A. E., Lin, E. & Mustard, C. A. (2002) Self-reported use of mental health services versus administrative records: should we care? International Journal of Methods in Psychiatric Research, 11, 125133.
Ritter, P. L., Stewart, A. L., Kaymaz, H., et al (2001) Self-reports of health care utilization compared to provider records. Journal of Clinical Epidemiology, 54, 136141.
Shah, F. V., Barnwell, B. G. & Bieler, G. S. (1997) SUDAAN User's Manual Release 8.0.1. Research Triangle Institute.
Stevens, A. & Raftery, J. (1994) Introduction in Health Care Needs Assessment: The Epidemiological Needs Assessment Review, vol. 1. Radcliffe
Wang, P. S., Demler, O. & Kessler, R. C. (2002) Adequacy of treatment for serious mental illness in the United States. American Journal of Public Health, 92, 9298.
Ware, J., Kosinski, M. & Keller, S. D. (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220233.
Wittchen, H.-U. (1994) Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research, 28, 5784.
Work Group on Major Depressive Disorder (2000) Practice Guideline for the Treatment of Patients with Major Depression. American Psychiatric Association.
Young, A. S., Klap, R., Sherbourne, C. D., et al (2001) The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58, 5561.

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Population level of unmet need for mental healthcare in Europe

  • Jordi Alonso (a1), Miquel Codony (a1), Viviane Kovess (a2), Matthias C. Angermeyer (a3), Steven J. Katz (a4), Josep M. Haro (a5), Giovanni De Girolamo (a6), Ron De Graaf (a7), Koen Demyttenaere (a8), Gemma Vilagut (a1), Josué Almansa (a1), Jean Pierre Lépine (a9) and Traolach S. Brugha (a10)...
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