The quality gap in mental health treatment in Australia

Jorm, Anthony F.

doi:10.1177/0004867415606224

Cited by 8 publications

(10 citation statements)

References 7 publications

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“…However, it now appears that this modelling was optimistic. The present analysis suggests that, in order to reduce the prevalence of common mental disorders, we may also need to reduce a “quality gap”. This gap has two components: providing treatments that meet the minimal standards of clinical practice guidelines, and targeting treatments optimally to those in greatest need.…”

Section: Discussionmentioning

confidence: 97%

Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries

et al. 2017

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Many people identified as having common mental disorders in community surveys do not receive treatment. Modelling has suggested that closing this "treatment gap" should reduce the population prevalence of those disorders. To evaluate the effects of reducing the treatment gap in industrialized countries, data from 1990 to 2015 were reviewed from four English-speaking countries: Australia, Canada, England and the US. These data show that the prevalence of mood and anxiety disorders and symptoms has not decreased, despite substantial increases in the provision of treatment, particularly antidepressants. Several hypotheses for this lack of improvement were considered. There was no support for the hypothesis that reductions in prevalence due to treatment have been masked by increases in risk factors. However, there was little evidence relevant to the hypothesis that improvements have been masked by increased reporting of symptoms because of greater public awareness of common mental disorders or willingness to disclose. A more strongly supported hypothesis for the lack of improvement is that much of the treatment provided does not meet the minimal standards of clinical practice guidelines and is not targeted optimally to those in greatest need. Lack of attention to prevention of common mental disorders may also be a factor. Reducing the prevalence of common mental disorders remains an unsolved challenge for health systems globally, which may require greater attention to the "quality gap" and "prevention gap". There is also a need for nations to monitor outcomes by using standardized measures of service provision and mental disorders over time.

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Section: Discussionmentioning

confidence: 97%

Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries

et al. 2017

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“…Prevalence of psychological distress was based on the K10 questionnaire (Andrews and Slade, 2001) administered in the National Health Surveys carried out in 2001, 2004-2005, 2007-2008, 2011-2012 and 2014-2015 to people aged 18 years or over (Australian Bureau of Statistics, 2002, 2009, 2012b, 2015. According to the Australian Bureau of Statistics (2017b), the data from these five surveys are considered to be directly comparable.…”

Section: Methodsmentioning

confidence: 99%

Australia’s ‘Better Access’ scheme: Has it had an impact on population mental health?

Jorm

2018

Aust N Z J Psychiatry

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Background: Australia introduced the Better Access scheme in late 2006, which resulted in a large increase in the provision of mental health services by general practitioners (GPs), clinical psychologists, other psychologists and allied health professionals. It is unknown whether this increase in services has had an effect on the mental health of the population. Methods: The following data were examined: per capita use of mental health services provided by GPs, clinical psychologists, other psychologists, allied health professionals and psychiatrists from 2006 to 2015 according to the Australian Government Department of Human Services; prevalence of psychological distress in adults (as measured by the K10)

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“…It emphasizes both a well-delineated treatment gap, whereby many patients with depression or anxiety do not receive treatment, and a quality gap whereby those who are treated either do not need to be treated or do not receive effective treatment. [2][3][4][5][6][7] Several factors contribute to these gaps. Even knowledgeable and well-intentioned physicians face competing demands, including the need to concurrently address medical comorbidities and social determinants of health, making identification and management of common mental disorders challenging.…”

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confidence: 99%

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confidence: 99%

Can Collaborative Care Cure the Mediocrity of Usual Care for Common Mental Disorders?

et al. 2018

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The quality gap in mental health treatment in Australia

Cited by 8 publications

References 7 publications

Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries

Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries

Australia’s ‘Better Access’ scheme: Has it had an impact on population mental health?

Can Collaborative Care Cure the Mediocrity of Usual Care for Common Mental Disorders?

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