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Proportion of patients without mental disorders being treated in mental health services worldwide

  • Ronny Bruffaerts (a1), Jose Posada-Villa (a2), Ali Obaid Al-Hamzawi (a3), Oye Gureje (a4), Yueqin Huang (a5), Chiyi Hu (a6), Evelyn J. Bromet (a7), Maria Carmen Viana (a8), Hristo Ruskov Hinkov (a9), Elie G. Karam (a10), Guilherme Borges (a11), Silvia E. Florescu (a12), David R. Williams (a13), Koen Demyttenaere (a14), Viviane Kovess-Masfety (a15), Herbert Matschinger (a16), Daphna Levinson (a17), Giovanni de Girolamo (a18), Yutaka Ono (a19), Ron de Graaf (a20), Mark Oakley Browne (a21), Brendan Bunting (a22), Miguel Xavier (a23), Josep Maria Haro (a24) and Ronald C. Kessler (a25)...

Abstract

Background

Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.

Aims

To examine the association of past-year mental health treatment with DSM-IV disorders.

Method

The World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.

Results

Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.

Conclusions

The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.

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Copyright

Corresponding author

Ronny Bruffaerts, Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), campus Leuven, Herestraat 49, B-3000 Leuven, Belgium. Email: ronny.bruffaerts@med.kuleuven.be.

Footnotes

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This report is carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. These activities were supported by the United States National Institute of Mental Health (R01MH070884), the Mental Health Burden Study: Contract number HHSN271200700030C, the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, the Eli Lilly & Company Foundation, Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, Bristol-Myers Squibb and Shire. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/. The São Paulo Megacity Mental Health Survey is supported by the State of São Paulo Research Foundation (FAPESP) Thematic Project Grant 03/00204-3. The Bulgarian Epidemiological Study of common mental disorders EPIBUL is supported by the Ministry of Health and the National Center for Public Health Protection. The Chinese World Mental Health Survey Initiative is supported by the Pfizer Foundation. The Shenzhen Mental Health Survey is supported by the Shenzhen Bureau of Health and the Shenzhen Bureau of Science, Technology, and Information. The Colombian National Study of Mental Health (NSMH) is supported by the Ministry of Social Protection. The ESEMeD project is funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP), and other local agencies and by an unrestricted educational grant from GlaxoSmithKline. The Epidemiological Study on Mental Disorders in India was funded jointly by Government of India and WHO. Implementation of the Iraq Mental Health Survey (IMHS) and data entry were carried out by the staff of the Iraqi MOH and MOP with direct support from the Iraqi IMHS team with funding from both the Japanese and European Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF). The Israel National Health Survey is funded by the Ministry of Health with support from the Israel National Institute for Health Policy and Health Services Research and the National Insurance Institute of Israel. The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013) from the Japan Ministry of Health, Labour and Welfare. The Lebanese National Mental Health Survey (LEBANON) is supported by the Lebanese Ministry of Public Health, the WHO (Lebanon), Fogarty International, anonymous private donations to IDRAAC, Lebanon, and unrestricted grants from Janssen Cilag, Eli Lilly, GlaxoSmithKline, Roche and Novartis. The Mexican National Comorbidity Survey (MNCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544-H), with supplemental support from the PanAmerican Health Organization (PAHO). Te Rau Hinengaro: The New Zealand Mental Health Survey (NZMHS) is supported by the New Zealand Ministry of Health, Alcohol Advisory Council and the Health Research Council. The Nigerian Survey of Mental Health and Wellbeing (NSMHW) is supported by the WHO (Geneva), the WHO (Nigeria) and the Federal Ministry of Health, Abuja, Nigeria. The Northern Ireland Study of Mental Health was funded by the Health & Social Care Research & Development Division of the Public Health Agency. The Romania WMH study projects ‘Policies in Mental Health Area’ and ‘National Study regarding Mental Health and Services Use’ were carried out by National School of Public Health & Health Services Management (former National Institute for Research & Development in Health), with technical support of Metro Media Transilvania, the National Institute of Statistics-National Centre for Training in Statistics, SC. Cheyenne Services SRL, Statistics Netherlands and were funded by Ministry of Public Health (former Ministry of Health) with supplemental support of Eli Lilly Romania SRL. The South Africa Stress and Health Study (SASH) is supported by the US National Institute of Mental Health (R01-MH059575) and National Institute of Drug Abuse with supplemental funding from the South African Department of Health and the University of Michigan. The Ukraine Comorbid Mental Disorders during Periods of Social Disruption (CMDPSD) study is funded by the US National Institute of Mental Health (RO1-MH61905). The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044708) and the John W. Alden Trust.

Declaration of interest

R.C.K. has been a consultant for Hoffman–La Roche, Johnson & Johnson Wellness and Prevention, and Sanofi–Aventis, and has served on advisory boards for Mensante Corporation, Plus One Health Management, Lake Nona Institute and US Preventive Medicine. He owns a 25% share in DataStat.

Footnotes

References

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Proportion of patients without mental disorders being treated in mental health services worldwide

  • Ronny Bruffaerts (a1), Jose Posada-Villa (a2), Ali Obaid Al-Hamzawi (a3), Oye Gureje (a4), Yueqin Huang (a5), Chiyi Hu (a6), Evelyn J. Bromet (a7), Maria Carmen Viana (a8), Hristo Ruskov Hinkov (a9), Elie G. Karam (a10), Guilherme Borges (a11), Silvia E. Florescu (a12), David R. Williams (a13), Koen Demyttenaere (a14), Viviane Kovess-Masfety (a15), Herbert Matschinger (a16), Daphna Levinson (a17), Giovanni de Girolamo (a18), Yutaka Ono (a19), Ron de Graaf (a20), Mark Oakley Browne (a21), Brendan Bunting (a22), Miguel Xavier (a23), Josep Maria Haro (a24) and Ronald C. Kessler (a25)...

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Proportion of patients without mental disorders being treated in mental health services worldwide

  • Ronny Bruffaerts (a1), Jose Posada-Villa (a2), Ali Obaid Al-Hamzawi (a3), Oye Gureje (a4), Yueqin Huang (a5), Chiyi Hu (a6), Evelyn J. Bromet (a7), Maria Carmen Viana (a8), Hristo Ruskov Hinkov (a9), Elie G. Karam (a10), Guilherme Borges (a11), Silvia E. Florescu (a12), David R. Williams (a13), Koen Demyttenaere (a14), Viviane Kovess-Masfety (a15), Herbert Matschinger (a16), Daphna Levinson (a17), Giovanni de Girolamo (a18), Yutaka Ono (a19), Ron de Graaf (a20), Mark Oakley Browne (a21), Brendan Bunting (a22), Miguel Xavier (a23), Josep Maria Haro (a24) and Ronald C. Kessler (a25)...
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