Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys

Wang, Philip S.; Aguilar‐Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias C.; Borges, Guilherme; Bromet, Evelyn J.; Bruffærts, Ronny; Girolamo, Giovanni de; Graaf, Ron de; Gureje, Oye; Haro, Josep María; Karam, Elie G.; Kessler, Ronald C.; Kovess, Viviane; Lane, Michael; Lee, Paul; Levinson, Daphna; Ono, Yutaka; Petukhova, Maria; Posada‐Villa, José; Seedat, Soraya; Wells, J. Elisabeth

doi:10.1016/s0140-6736(07)61414-7

Cited by 1,336 publications

(1,125 citation statements)

References 25 publications

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“…PTSD causes substantial loss of human capital from a societal perspective both in the form of days out of role (Alonso et al, 2011) and in the form of decreased productivity on days in role (Ormel et al, 2008). Roughly half of people with PTSD in high income countries and about half that number in low or middle income countries seek some type of treatment (Koenen et al, 2017), but the type and duration of treatment seldom meet even minimal standards for treatment adequacy (Wang et al, 2007). These results suggest that outreach efforts are needed to increase the proportion of people with PTSD who obtain treatment and that treatment quality improvement efforts are needed for patients in treatment.…”

Section: Resultsmentioning

confidence: 99%

Trauma and PTSD in the WHO World Mental Health Surveys

Kessler

Aguilar‐Gaxiola

Alonso

et al. 2017

European Journal of Psychotraumatology

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Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’ Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.

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Section: Resultsmentioning

confidence: 99%

Trauma and PTSD in the WHO World Mental Health Surveys

Kessler

Aguilar‐Gaxiola

Alonso

et al. 2017

European Journal of Psychotraumatology

Self Cite

906

659

View full text Add to dashboard Cite

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“…This may be due to stigma associated with mental health problems among men or their inability to recognize feelings of distress and seek help (Wang et al 2007;Mojtabai, 2010;Evans-Lacko et al 2014).…”

Section: Discussionmentioning

confidence: 99%

Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study

et al. 2016

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Background. Research supports robust associations between childhood bullying victimization and mental health problems in childhood/adolescence and emerging evidence shows that the impact can persist into adulthood. We examined the impact of bullying victimization on mental health service use from childhood to midlife.Method. We performed secondary analysis using the National Child Development Study, the 1958 British Birth Cohort Study. We conducted analyses on 9242 participants with complete data on childhood bullying victimization and service use at midlife. We used multivariable logistic regression models to examine associations between childhood bullying victimization and mental health service use at the ages of 16, 23, 33, 42 and 50 years. We estimated incidence and persistence of mental health service use over time to the age of 50 years.Results. Compared with participants who were not bullied in childhood, those who were frequently bullied were more likely to use mental health services in childhood and adolescence [odds ratio (OR) 2.53, 95% confidence interval (CI) 1.88-3.40] and also in midlife (OR 1.30, 95% CI 1.10-1.55). Disparity in service use associated with childhood bullying victimization was accounted for by both incident service use through to age 33 years by a subgroup of participants, and by persistent use up to midlife.Conclusions. Childhood bullying victimization adds to the pressure on an already stretched health care system. Policy and practice efforts providing support for victims of bullying could help contain public sector costs. Given constrained budgets and the long-term mental health impact on victims of bullying, early prevention strategies could be effective at limiting both individual distress and later costs.

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“…In low-and middle-income settings, where provision is lower, even more go untreated (Wang et al 2007). Although mental health problems may be self-limiting or respond to self-or lay-help (Oliver et al 2005a), when individuals delay or avoid formal care this can have problematic consequences.…”

Section: Introductionmentioning

confidence: 99%

What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies

et al. 2014

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Background. Individuals often avoid or delay seeking professional help for mental health problems. Stigma may be a key deterrent to help-seeking but this has not been reviewed systematically. Our systematic review addressed the overarching question: What is the impact of mental health-related stigma on help-seeking for mental health problems? Subquestions were: (a) What is the size and direction of any association between stigma and help-seeking? (b) To what extent is stigma identified as a barrier to help-seeking? (c) What processes underlie the relationship between stigma and help-seeking? (d) Are there population groups for which stigma disproportionately deters help-seeking?Method. Five electronic databases were searched from 1980 to 2011 and references of reviews checked. A meta-synthesis of quantitative and qualitative studies, comprising three parallel narrative syntheses and subgroup analyses, was conducted.Results. The review identified 144 studies with 90 189 participants meeting inclusion criteria. The median association between stigma and help-seeking was d = − 0.27, with internalized and treatment stigma being most often associated with reduced help-seeking. Stigma was the fourth highest ranked barrier to help-seeking, with disclosure concerns the most commonly reported stigma barrier. A detailed conceptual model was derived that describes the processes contributing to, and counteracting, the deterrent effect of stigma on help-seeking. Ethnic minorities, youth, men and those in military and health professions were disproportionately deterred by stigma.Conclusions. Stigma has a small-to moderate-sized negative effect on help-seeking. Review findings can be used to help inform the design of interventions to increase help-seeking.

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Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys

Cited by 1,336 publications

References 25 publications

Trauma and PTSD in the WHO World Mental Health Surveys

Trauma and PTSD in the WHO World Mental Health Surveys

Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study

What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies

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