Barriers to mental health treatment: results from the WHO World Mental Health surveys

Abstract

Background To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. Methods Data are from the 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= 63,678) and analyzed at different levels of clinical severity. Results Among those with a DSM-IV disorder in the past twelve 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. 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 both to 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 dropout (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.

Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD

“…The main premise here is that the best evidence-based approach for assessing or treating a clinical health condition serves little value if clients do not seek it out and participate in it. There are many reasons why barriers to care limit client participation in clinical interventions that could ultimately provide benefit (Andrade et al, 2014; Clement, Schauman, Graham, Maggioni, & Evans-Lacko et al, 2015). To address this issue, we have constructed an intuitive model (Rizzo & Koenig, in press) for detailing and examining core barriers, referred to as the ‘7A’s’.…”

Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses

“…This heightened attention is, in part, due to the important associations between stigma and the severity of mental illness symptoms (Andrade et al 2014;Brown 2017;Drapalski et al 2013), disclosure of conditions to friends, family, and healthcare professionals (Dew et al 2007;Donnelly 2017;Prior et al 2003), self-esteem (Corrigan 2004;Corrigan and Watson 2002;Corrigan, Watson, and Barr 2006), and treatment-seeking behavior (Clement et al 2015;Tsang, Fung, and Chung 2010;Vogel, Wade, and Haake 2006). While population estimates suggest that many individuals with symptoms of mental illness do not receive treatment or are undertreated Wang et al 2005Wang et al , 2007, scholars, healthcare providers, and other stakeholders hope that stigma reduction efforts will increase treatment-seeking behavior (Clair, Daniel, and Lamont 2016;Hatzenbuehler, Phelan, and Link 2013;Hunter et al 2017;Pilgrim and Rogers 2005).…”

Predictors of Mental Health Service Use by Young Adults: A Systematic Review

“…Future research should focus on developing psychoeducational interventions targeted at young men and racial-ethnic minority groups, in addition to informing young adults of the success of mental health counseling in the absence of a diagnosis. Investigating biopsychosocial predictors of help seeking among young adults (ages [18][19][20][21][22][23][24] is important because mental disorders typically present during young adulthood (1,2), the prevalence of mental illnesses is high in this age cohort (3), and young adults underuse services (4-7). However, much of the available counseling research has either targeted distinct subgroups, such as college students (8)(9)(10), or focused on help-seeking intention as the sole determinant of behavior, despite the questionable relationship between intention and actual service use (11,12).…”