Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys
Abstract Background High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. Methods Data on barriers were obtained from face-to-face interviews in 22 community surveys ac...
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2025-02-01
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| Series: | International Journal of Mental Health Systems |
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| Online Access: | https://doi.org/10.1186/s13033-024-00658-2 |
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| author | Maria Carmen Viana Alan E. Kazdin Meredith G. Harris Dan J. Stein Daniel V. Vigo Irving Hwang Sophie M. Manoukian Nancy A. Sampson Jordi Alonso Laura Helena Andrade Guilherme Borges Brendan Bunting José Miguel Caldas-de-Almeida Giovanni de Girolamo Peter de Jonge Oye Gureje Josep Maria Haro Elie G. Karam Viviane Kovess-Masfety Jacek Moskalewicz Fernando Navarro-Mateu Daisuke Nishi Marina Piazza José Posada-Villa Kate M. Scott Cristian Vladescu Bogdan Wojtyniak Zahari Zarkov Ronald C. Kessler Timothy Kessler World Mental Health Survey collaborators |
| author_facet | Maria Carmen Viana Alan E. Kazdin Meredith G. Harris Dan J. Stein Daniel V. Vigo Irving Hwang Sophie M. Manoukian Nancy A. Sampson Jordi Alonso Laura Helena Andrade Guilherme Borges Brendan Bunting José Miguel Caldas-de-Almeida Giovanni de Girolamo Peter de Jonge Oye Gureje Josep Maria Haro Elie G. Karam Viviane Kovess-Masfety Jacek Moskalewicz Fernando Navarro-Mateu Daisuke Nishi Marina Piazza José Posada-Villa Kate M. Scott Cristian Vladescu Bogdan Wojtyniak Zahari Zarkov Ronald C. Kessler Timothy Kessler World Mental Health Survey collaborators |
| author_sort | Maria Carmen Viana |
| collection | DOAJ |
| description | Abstract Background High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. Methods Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.7% female, median age [interquartile range]: 43 [31–57] years; 68.5% weighted average response rate) in the World Mental Health (WMH) surveys. We focus on the n = 5,136 respondents with 12-month DSM-IV anxiety, mood, or substance use disorders with perceived need for treatment. The n = 2,444 such respondents who did not receive treatment were asked about barriers to receiving treatment, whereas the n = 926 respondents who received treatment with a delay were asked about barriers leading to delays. Consistent with previous research, we distinguished five broad classes of barriers: low perceived disorder severity, two types of barriers in the domain of predisposing factors (beliefs/attitudes about treatment ineffectiveness and stigma) and two types in the domain of enabling factors (financial and nonfinancial). Baseline predictors of receiving treatment found in a prior report (i.e., comparing the n = 2,692 respondents who received treatment with the n = 2,444 who did not) were examined as predictors of barriers, while barriers were examined as mediators of associations between these predictors and treatment. Results Most respondents reported multiple barriers. Barriers among respondents who did not receive treatment included low perceived severity (52.9%), perceived treatment ineffectiveness (44.8%), nonfinancial (40.2%) and financial (32.9%) barriers in the domain of enabling factors, and stigma (20.6%). Barriers causing delays in treatment had a similar rank-order but were reported by higher proportions of respondents (X2 1 = 3.8–199.8, p = 0.050− < 0.001). Barriers were predicted by low education, disorder type, age, employment status, and financial obstacles. Predictors varied as a function of barrier type. Conclusions A wide range of barriers to treatment exist among people with mental disorders even after a need for treatment is acknowledged. Most such individuals have multiple barriers. These results have important implications for the design of programs to decrease unmet need for treatment of mental disorders. |
| format | Article |
| id | doaj-art-d802217c20ca4ac2928e67d09bc64d50 |
| institution | Kabale University |
| issn | 1752-4458 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Mental Health Systems |
| spelling | doaj-art-d802217c20ca4ac2928e67d09bc64d502025-02-09T12:12:50ZengBMCInternational Journal of Mental Health Systems1752-44582025-02-0119111810.1186/s13033-024-00658-2Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveysMaria Carmen Viana0Alan E. Kazdin1Meredith G. Harris2Dan J. Stein3Daniel V. Vigo4Irving Hwang5Sophie M. Manoukian6Nancy A. Sampson7Jordi Alonso8Laura Helena Andrade9Guilherme Borges10Brendan Bunting11José Miguel Caldas-de-Almeida12Giovanni de Girolamo13Peter de Jonge14Oye Gureje15Josep Maria Haro16Elie G. Karam17Viviane Kovess-Masfety18Jacek Moskalewicz19Fernando Navarro-Mateu20Daisuke Nishi21Marina Piazza22José Posada-Villa23Kate M. Scott24Cristian Vladescu25Bogdan Wojtyniak26Zahari Zarkov27Ronald C. Kessler28Timothy Kessler29World Mental Health Survey collaboratorsDepartment of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito SantoDepartment of Psychology, Yale UniversitySchool of Public Health, The University of Queensland, C/O QCMHRDepartment of Psychiatry & Mental Health and South African Medical Council Research Unit On Risk and Resilience in Mental Disorders, University of Cape TownDepartment of Psychiatry & School of Population and Public Health, Faculty of Medicine, University of British Columbia, UBC Hospital – Detwiller PavilionDepartment of Health Care Policy, Harvard Medical SchoolDepartment of Health Care Policy, Harvard Medical SchoolDepartment of Health Care Policy, Harvard Medical SchoolIMIM-Hospital del Mar Medical Research Institute, PRBB BuildingUniversity of São Paulo Medical SchoolNational Institute of Psychiatry Ramón de La Fuente MuñizSchool of Psychology, Ulster UniversityLisbon Institute for Global Mental Health, Comprehensive Health Research Centre Nova University of LisbonIRCCS Istituto Centro San Giovanni Di Dio FatebenefratelliDepartment of Developmental Psychology, University of GroningenDepartment of Psychiatry, University of Ibadan, University College HospitalParc Sanitari Sant Joan de DéuInstitute for Development, Research, Advocacy and Applied Care (IDRAAC)Institut de Psychologie, UR 4057, Université Paris CitéDepartment of Psychiatry, Institute of Psychiatry and NeurologyUnidad de Docencia, Investigacion y Formación en Salud Mental, Servicio Murciano de Salud, Murcia Health Service, C/LorcaDepartment of Mental Health, Graduate School of Medicine, The University of TokyoFacultad de Salud Pública y Administración, Universidad Peruana Cayetano HerediaColombian Institute of the Nervous System, Clinica Montserrat University HospitalDepartment of Psychological Medicine, University of OtagoNational Institute for Health Services ManagementNational Institute of Public Health, National Research InstituteDepartment of Mental Health, National Center of Public Health and AnalysesDepartment of Health Care Policy, Harvard Medical SchoolThe Watson Institute for International and Public Affairs, Brown UniversityAbstract Background High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. Methods Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.7% female, median age [interquartile range]: 43 [31–57] years; 68.5% weighted average response rate) in the World Mental Health (WMH) surveys. We focus on the n = 5,136 respondents with 12-month DSM-IV anxiety, mood, or substance use disorders with perceived need for treatment. The n = 2,444 such respondents who did not receive treatment were asked about barriers to receiving treatment, whereas the n = 926 respondents who received treatment with a delay were asked about barriers leading to delays. Consistent with previous research, we distinguished five broad classes of barriers: low perceived disorder severity, two types of barriers in the domain of predisposing factors (beliefs/attitudes about treatment ineffectiveness and stigma) and two types in the domain of enabling factors (financial and nonfinancial). Baseline predictors of receiving treatment found in a prior report (i.e., comparing the n = 2,692 respondents who received treatment with the n = 2,444 who did not) were examined as predictors of barriers, while barriers were examined as mediators of associations between these predictors and treatment. Results Most respondents reported multiple barriers. Barriers among respondents who did not receive treatment included low perceived severity (52.9%), perceived treatment ineffectiveness (44.8%), nonfinancial (40.2%) and financial (32.9%) barriers in the domain of enabling factors, and stigma (20.6%). Barriers causing delays in treatment had a similar rank-order but were reported by higher proportions of respondents (X2 1 = 3.8–199.8, p = 0.050− < 0.001). Barriers were predicted by low education, disorder type, age, employment status, and financial obstacles. Predictors varied as a function of barrier type. Conclusions A wide range of barriers to treatment exist among people with mental disorders even after a need for treatment is acknowledged. Most such individuals have multiple barriers. These results have important implications for the design of programs to decrease unmet need for treatment of mental disorders.https://doi.org/10.1186/s13033-024-00658-2Mental disordersBarriers to treatmentMental disorder treatmentTreatment gapUse of health servicesTreatment delays |
| spellingShingle | Maria Carmen Viana Alan E. Kazdin Meredith G. Harris Dan J. Stein Daniel V. Vigo Irving Hwang Sophie M. Manoukian Nancy A. Sampson Jordi Alonso Laura Helena Andrade Guilherme Borges Brendan Bunting José Miguel Caldas-de-Almeida Giovanni de Girolamo Peter de Jonge Oye Gureje Josep Maria Haro Elie G. Karam Viviane Kovess-Masfety Jacek Moskalewicz Fernando Navarro-Mateu Daisuke Nishi Marina Piazza José Posada-Villa Kate M. Scott Cristian Vladescu Bogdan Wojtyniak Zahari Zarkov Ronald C. Kessler Timothy Kessler World Mental Health Survey collaborators Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys International Journal of Mental Health Systems Mental disorders Barriers to treatment Mental disorder treatment Treatment gap Use of health services Treatment delays |
| title | Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys |
| title_full | Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys |
| title_fullStr | Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys |
| title_full_unstemmed | Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys |
| title_short | Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys |
| title_sort | barriers to 12 month treatment of common anxiety mood and substance use disorders in the world mental health wmh surveys |
| topic | Mental disorders Barriers to treatment Mental disorder treatment Treatment gap Use of health services Treatment delays |
| url | https://doi.org/10.1186/s13033-024-00658-2 |
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