Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders in the National Comorbidity Survey Replication

Wang, Philip S.; Berglund, Patricia A.; Olfson, Mark; Pincus, Harold Alan; Wells, Kenneth B.; Kessler, Ronald C.

doi:10.1001/archpsyc.62.6.603

Cited by 1,193 publications

(913 citation statements)

References 86 publications

Supporting

Mentioning

835

Contrasting

Unclassified

Order By: Relevance

“…However, the perception that the problem was not severe (61%) and thinking that the problem would get better (82%) were the most prevalent attitudinal barriers that emerged from the SASH data (24). The combination of these attitudinal barriers may contribute substantially to the well-documented delays between onset and treatment of mental disorders (49,50). …”

Section: Discussionmentioning

confidence: 99%

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Bruwer

Sorsdahl²,

Harrison³

et al. 2011

Psychiatric Services

View full text Add to dashboard Cite

Objective This study used data from the South African Stress and Health Study (SASH) to examine both structural and attitudinal barriers to treatment initiation among South Africans with mental disorders and to investigate predictors of treatment dropout. Methods Face-to-face interviews were conducted with 4,315 adult South Africans living in households or hostel quarters. The interview included a core diagnostic assessment of past-12-month mental disorders and assessments of disorder severity, service use, and barriers to treatment. Multivariate logistic regression models were used to determine predictors of not seeking treatment in relation to disorder severity and sociodemographic characteristics, as well as factors that were predictive of premature treatment discontinuation by participants who had received mental health treatment in the previous 12 months. Predictors of dropout were identified by cross-tabulation and discrete-time survival analysis. Results Of the 4,315 adults, 729 (16.9% weighted) met criteria for a mental disorder in the past 12 months. Across all levels of severity, the most frequently cited reason for not seeking professional treatment was a low perceived need for treatment. Among those who recognized the need but did not access treatment during the past 12 months (7.2%), attitudinal barriers to treatment seeking were reported more commonly than structural barriers (100% and 34%, respectively). Of the 182 respondents who received treatment (25% weighted), 20% discontinued prematurely. Various factors, such as substance use disorders and absence of health insurance, increased the odds of treatment dropout. Conclusions Low rates of treatment seeking and high treatment dropout rates for common mental disorders among South Africans are a major concern. Public health efforts to improve treatment of mental disorders should consider the multiple influences on treatment initiation and discontinuation.

show abstract

Section: Discussionmentioning

confidence: 99%

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Bruwer

Sorsdahl²,

Harrison³

et al. 2011

Psychiatric Services

View full text Add to dashboard Cite

show abstract

“…However, it is well established that due to barriers in seeking and obtaining care, patients typically experience mental health symptoms for years prior to their date of diagnosis. [38][39][40] In addition, we cannot determine the direction of the association between mental disorders and increased non-mental health service utilization. Finally, though our analyses provide information on veterans' use of VA services, detailed economic analyses and analyses of the VA's capacity to meet demand for services were beyond the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans

Cohen¹,

Gima²,

Bertenthal³

et al. 2010

PsycEXTRA Dataset

View full text Add to dashboard Cite

“…In the second approach, questions regarding service utilization are located at the end of specific diagnostic modules. Through both context and wording, these questions are linked explicitly to the psychiatric symptomatology elicited by that diagnostic module (Kessler et al, 1998;Kessler and Ustun, 2004;Olfson et al, 1998;Vega et al, 1999;Wang et al, 2005a). Interestingly, some studies have included both separate service utilization modules and diagnosis-specific service utilization questions (Kessler et al, 1997a;Kessler et al, 1998;Kessler et al, 1999;Kessler, 2000;Kessler and Ustun, 2004;Olfson et al, 1998; US Department of Health and Human Services, 2000;Wang et al, 2005a;Wang et al, 2005b;Wang et al, 2006;Wu et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Methods for measuring utilization of mental health services in two epidemiologic studies

Novins

Beals

Croy

et al. 2008

Int J Methods Psych Res

View full text Add to dashboard Cite

Objectives of Study-Psychiatric epidemiologic studies often include two or more sets of questions regarding service utilization, but the agreement across these different questions and the factors associated with their endorsement have not been examined. The objectives of this study were to describe the agreement of different sets of mental health service utilization questions that were included in the American Indian Service Utilization Psychiatric Epidemiology Risk and Protective Factors Project (AI-SUPERPFP), and compare the results to similar questions included in the baseline National Comorbidity Survey (NCS).Methods-Responses to service utilization questions by 2878 AI-SUPERPFP and 5877 NCS participants were examined by calculating estimates of service use and agreement (κ) across the different sets of questions. Logistic regression models were developed to identify factors associated with endorsement of specific sets of questions.Results-In both studies, estimates of mental health service utilization varied across the different sets of questions. Agreement across the different question sets was marginal to good (κ = 0.27-0.69). Characteristics of identified service users varied across the question sets.Limitations-Neither survey included data to examine the validity of participant responses to service utilization questions.Recommendations for Further Research-Question wording and placement appear to impact estimates of service utilization in psychiatric epidemiologic studies. Given the importance of these estimates for policy-making, further research into the validity of survey responses as well as impacts of question wording and context on rates of service utilization is warranted.

show abstract

Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders in the National Comorbidity Survey Replication

Abstract: Failure to make prompt initial treatment contact is a pervasive aspect of unmet need for mental health care in the United States. Interventions to speed initial treatment contact are likely to reduce the burdens and hazards of untreated mental disorder.

Cited by 1,193 publications

References 86 publications

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans

Methods for measuring utilization of mental health services in two epidemiologic studies

Contact Info

Product

Resources

About