Journal
PSYCHOLOGICAL MEDICINE
Volume 44, Issue 6, Pages 1303-1317Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291713001943
Keywords
Continuity; mental health care; treatment seeking
Categories
Funding
- National Institute of Mental Health (NIMH) [R01 MH070884]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- US Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center [FIRCA R03-TW006481]
- Pan American Health Organization
- Eli Lilly and Company
- Ortho-McNeil Pharmaceutical
- GlaxoSmithKline
- Bristol-Myers Squibb
- State of Sao Paulo Research Foundation (FAPESP) Thematic Project [03/00 204-3]
- Ministry of Health
- National Center for Public Health Protection
- Shenzhen Bureau of Health
- Shenzhen Bureau of Science, Technology and Information
- Ministry of Social Protection
- Saldarriaga Concha Foundation
- European Commission [QLG5-1999-01042, SANCO 2004 123, EAHC20081308]
- Piedmont Region (Italy)
- Fondo de Investigacion Sanitaria
- Instituto de Salud Carlos III, Spain [FIS 00/0028]
- Ministerio de Ciencia y Tecnologia, 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]
- WHO/Directorate General of Health Services (DGHS)
- United Nations Development Group Iraq Trust Fund (UNDG ITF)
- Israel National Institute for Health Policy and Health Services Research
- National Insurance Institute of Israel
- Grant for Research on Psychiatric and Neurological Diseases and Mental Health from the Japan Ministry of Health, Labor and Welfare [H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013]
- Lebanese Ministry of Public Health
- WHO (Lebanon)
- National Institute of Health/Fogarty International Center [R03 TW006481-01]
- Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences
- AstraZeneca
- Eli Lilly
- Hikma Pharm
- Pfizer
- Roche
- Sanofi-Aventis
- Servier
- Novartis
- National Institute of Psychiatry Ramon de la Fuente [INPRFMDIES 4280]
- National Council on Science and Technology [CONACyT-G30544-H]
- Pan American Health Organization (PAHO)
- New Zealand Ministry of Health
- Alcohol Advisory Council
- Health Research Council
- WHO (Geneva)
- WHO (Nigeria)
- Federal Ministry of Health, Abuja, Nigeria
- Health and Social Care Research and Development Division of the Public Health Agency
- Champalimaud Foundation
- Gulbenkian Foundation
- Foundation for Science and Technology (FCT)
- Ministry of Public Health
- Eli Lilly Romania SRL
- South African Department of Health
- University of Michigan
- US National Institute of Mental Health [RO1-MH61905]
- NIMH [U01-MH60220]
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Robert Wood Johnson Foundation (RWJF) [044780]
- John W. Alden Trust
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Background. To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. Method. Data were from the World Health Organization (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=63678) and analyzed at different levels of clinical severity. Results. Among those with a DSM-IV disorder in the past 12 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. A 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 to both 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 drop-out (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.
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