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DOI: 10.1017/s0033291717003336
¤ OpenAccess: Green
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Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys

Sara Evans‐Lacko,Sergio Aguilar‐Gaxiola,Ali Al‐Hamzawi,Jordi Alonso,Corina Benjet,Ronny Bruffærts,Wai Tat Chiu,Silvia Florescu,Giovanni de Girolamo,Oye Gureje,Josep María Haro,Yulong He,Chiyi Hu,Elie G. Karam,Norito Kawakami,S Lee,Crick Lund,Viviane Kovess‐Masfety,Daphna Levinson,Fernando Navarro‐Mateu,Beth Ellen Pennell,Nancy A. Sampson,Kate M. Scott,Hisateru Tachimori,Margreet ten Have,María Carmen Viana,Daniel Williams,Bogdan Wojtyniak,Zahari Zarkov,R. C. Kessler,Somnath Chatterji,Graham Thornicroft

CIDI
Mental health
Psychiatry
2017
Abstract Background The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio-economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data. Methods Data come from 16 753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI). Results Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive with education (highest treatment among respondents with the highest education and a weak association of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes). Conclusions The modest, but nonetheless stronger, an association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association of SES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.
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    Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys” is a paper by Sara Evans‐Lacko Sergio Aguilar‐Gaxiola Ali Al‐Hamzawi Jordi Alonso Corina Benjet Ronny Bruffærts Wai Tat Chiu Silvia Florescu Giovanni de Girolamo Oye Gureje Josep María Haro Yulong He Chiyi Hu Elie G. Karam Norito Kawakami S Lee Crick Lund Viviane Kovess‐Masfety Daphna Levinson Fernando Navarro‐Mateu Beth Ellen Pennell Nancy A. Sampson Kate M. Scott Hisateru Tachimori Margreet ten Have María Carmen Viana Daniel Williams Bogdan Wojtyniak Zahari Zarkov R. C. Kessler Somnath Chatterji Graham Thornicroft published in 2017. It has an Open Access status of “green”. You can read and download a PDF Full Text of this paper here.