More people are seeking mental health help than a decade ago, but most people with diagnosable mental illnesses still lack treatment, a new study shows.
The report appears in The New England Journal of Medicine's June 16th issue. It's based on face-to-face interviews with thousands of people. Topics covered included anxiety disorders, mood disorders (including depression and bipolar disorder), and substance abuse.
Those problems are treatable. Health experts universally encourage people to seek help for mental health issues. Wise attention from a doctor or counselor may make a big difference; so can lifestyle changes and, for some people, medications.
Interviews were done in 1990-1992 and again in 2001-2003. The first survey included people aged 15-54; the second focused on adults aged 18 and older.
The interviews included questions about symptoms and treatments over the previous year. The answers were compared with official diagnosis standards.
About three out of 10 adults in both studies had some form of mental illness or substance abuse problem in both studies (29 percent in 1990-1992 and 30 percent in 2001-2002).
Treatment increased during that time. In the first survey, 12 percent of adults aged 18-54 said they'd gotten mental health treatment in the previous year. A decade later, that number had risen to 20 percent, or one in five adults.
The first survey included more than 5,300 people; the second had more than 4,300 participants. None were homeless or in institutions. Treatment included general medical, psychiatric, mental health, complementary-alternative, and human services.
Room for Improvement
Harvard Medical School's Ronald Kessler, PhD, and colleagues took a closer look at the treatment numbers. They found that "most patients with a mental disorder did not receive treatment."
Some people who'd gotten help didn't have a diagnosable disorder. That's not to say that their issues weren't important or deserving of attention. However, it does show that many other people who need help aren't getting it.
The proportional increase in treatment rate was "essentially the same for all levels of severity," say researchers.
Social Gaps Remain
Gaps among social and demographic groups didn't narrow. For instance, blacks in both surveys were only half as likely as whites to get psychiatric treatment for a diagnosed disorder of the same severity, the study notes.
A 2001 report from the U.S. Surgeon General echoes that shortfall. "Racial and ethnic minorities have less access to mental health services than do whites," says the surgeon general's report. "They are less likely to receive needed care. When they receive care, it is more likely to be poor in quality."
Biggest Gain in Medical Treatment
Many people apparently turned to their doctors for mental health help.
The biggest increase in treatment type was in general medical services, which grew 2.5-fold between the surveys. Next came psychiatric services, which rose 2.17 times. Other mental health services increased 1.6-fold.
What about complementary-alternative medical and human services? They continue to account for a high proportion of patients seeking treatment, says the study.
No information was available on how well any of those treatments worked. However, Kessler writes that many people who sought general medical help didn't complete the clinical assessment or get treatment that meets accepted standards of care.
Researcher's Recent Findings
Kessler also has reports in June's Archives of General Psychiatry. Those findings include:
— More than 1 in 4 U.S. adults per year has some form of mental illness.
— Prompt, adequate treatment is the exception, not the rule.
— Most cases are mild, but 14 percent are moderate or severe.
SOURCES: Kessler, R. The New England Journal of Medicine, June 16, 2005; vol 352: pp 2515-2523. U.S. Surgeon General's Report: "Mental Health: Culture, Race, Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General." WebMD Medical News: "Mental Illness Common in the U.S."