| Abstract: | Data are presented on patterns of failure and delay in making initial treatmentcontact after first onset of a mental disorder in 15 countries in the WorldHealth Organization (WHO)''s World Mental Health (WMH) Surveys. Representativeface-to-face household surveys were conducted among 76,012 respondents aged18 and older in Belgium, Colombia, France, Germany, Israel, Italy, Japan,Lebanon, Mexico, the Netherlands, New Zealand, Nigeria, People''s Republicof China (Beijing and Shanghai), Spain, and the United States. The WHO CompositeInternational Diagnostic Interview (CIDI) was used to assess lifetime DSM-IVanxiety, mood, and substance use disorders. Ages of onset for individual disordersand ages of first treatment contact for each disorder were used to calculatethe extent of failure and delay in initial help seeking. The proportion oflifetime cases making treatment contact in the year of disorder onset rangedfrom 0.8 to 36.4% for anxiety disorders, from 6.0 to 52.1% for mood disorders,and from 0.9 to 18.6% for substance use disorders. By 50 years, the proportionof lifetime cases making treatment contact ranged from 15.2 to 95.0% for anxietydisorders, from 7.9 to 98.6% for mood disorders, and from 19.8 to 86.1% forsubstance use disorders. Median delays among cases eventually making contactranged from 3.0 to 30.0 years for anxiety disorders, from 1.0 to 14.0 yearsfor mood disorders, and from 6.0 to 18.0 years for substance use disorders.Failure and delays in treatment seeking were generally greater in developingcountries, older cohorts, men, and cases with earlier ages of onset. Theseresults show that failure and delays in initial help seeking are pervasiveproblems worldwide. Interventions to ensure prompt initial treatment contactsare needed to reduce the global burdens and hazards of untreated mental disorders. |
