Twelve-month mental health service use in six countries of the Americas: A regional report from the World Mental Health Surveys

• Published in: Epidemiology and psychiatric sciences 2019-08, Vol.29, p.e53, Article e53
• Main Authors: Borges, G, Aguilar-Gaxiola, S, Andrade, L, Benjet, C, Cia, A, Kessler, R C, Orozco, R, Sampson, N, Stagnaro, J C, Torres, Y, Viana, Maria Carmen, Medina-Mora, M E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anxiety Disorders - epidemiology; Anxiety Disorders - therapy; Argentina - epidemiology; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention Deficit Disorder with Hyperactivity - therapy; Bipolar Disorder - epidemiology; Bipolar Disorder - therapy; Brazil - epidemiology; Colombia - epidemiology; Disruptive, Impulse Control, and Conduct Disorders - epidemiology; Disruptive, Impulse Control, and Conduct Disorders - therapy; Educational Status; Facilities and Services Utilization; Female; Health Services Accessibility; Humans; Income; Male; Mental Disorders - epidemiology; Mental Disorders - therapy; Mental Health Services - statistics & numerical data; Mexico - epidemiology; Middle Aged; Mood Disorders - epidemiology; Mood Disorders - therapy; Original; Peru - epidemiology; Practice Guidelines as Topic; Quality of Health Care; Severity of Illness Index; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; United States - epidemiology; Young Adult
• ISSN: 2045-7960; 2045-7979
• DOI: 10.1017/s2045796019000477

To provide cross-national data for selected countries of the Americas on service utilization for psychiatric and substance use disorders, the distribution of these services among treatment sectors, treatment adequacy and factors associated with mental health treatment and adequacy of treatment. Data come from data collected from 6710 adults with 12 month mental disorder surveys across seven surveys in six countries in North (USA), Central (Mexico) and South (Argentina, Brazil, Colombia, Peru) America who were interviewed 2001-2015 as part of the World Health Organization (WHO) World Mental Health (WMH) Surveys. DSM-IV diagnoses were made with the WHO Composite International Diagnostic Interview (CIDI). Interviews also assessed service utilization by the treatment sector, adequacy of treatment received and socio-demographic correlates of treatment. Little over one in four of respondents with any 12 month DSM-IV/CIDI disorder received any treatment. Although the vast majority (87.1%) of this treatment was minimally adequate, only 35.3% of cases received treatment that met acceptable quality guidelines. Indicators of social-advantage (high education and income) were associated with higher rates of service use and adequacy, but a number of other correlates varied across survey sites. These results shed light on an enormous public health problem involving under-treatment of common mental disorders, although the problem is most extreme among people with social disadvantage. Promoting services that are more accessible, especially for those with few resources, is urgently needed.