The Great Mental Health Failure: 93% of Patients with Mental Disorders Do Not Receive Adequate Treatment

After analyzing data from 21 countries, the findings were alarming. Only 6.9% of people with mental disorders received treatment considered effective. The results show that the biggest barrier to treatment is not the lack of doctors or medications, but rather the awareness of the population itself about the need to seek help.

The most common mental disorders include anxiety, depression, bipolar disorder and drug addiction, affecting millions of people globally. Anxiety and depression are the most prevalent, impacting approximately 4% to 7% of the population annually.

Disorders such as schizophrenia and bipolar disorder are less common, but can be highly disabling. Mental disorders and substance abuse affect millions of people worldwide, but how many actually receive adequate treatment?

Access to treatment remains a challenge, making awareness and support for mental health essential. A study conducted in 21 countries analyzed this issue and came up with worrying conclusions: the majority of people suffering from these problems do not receive effective treatment.

Researchers at the University of British Columbia in Canada surveyed 56,927 adults, 32,829 (57.7%) of whom were women and had a median age of 43, and assessed whether those with anxiety, mood disorders (such as depression) and substance use disorders (such as alcohol dependence) were receiving treatment that was consistent with medical guidelines.

The data was collected between 2001 and 2019, and the results were analyzed in 2024.

The findings were alarming. Only 6.9% of people with mental disorders received treatment that was considered effective. The survey identified three main barriers that prevent greater access to appropriate care:

1. Lack of awareness of the need for treatment – ​​Almost half of people (46.5%) simply did not believe they needed medical help, even though they had a diagnosable disorder.

   
   

2. Low contact with health services – About 34.1% of people did not seek care, often because they did not know they needed treatment.

   
   

3. Inadequate treatment – ​​Even among those who sought help, 47% received treatment that was considered insufficient to truly improve their condition.

The study also revealed that access to mental health treatment remains very limited in many countries. Interestingly, health systems focused on general care appear to have a greater impact on access to treatment than specific mental health services.

In addition, factors such as education level, income and access to health insurance influenced treatment seeking. Men and people with less education had greater difficulty receiving adequate care.

The results show that the biggest barrier to treatment is not the lack of doctors or medication, but rather the population's awareness of the need to seek help.

To change this scenario, the researchers suggest some actions. Increase information about mental disorders so that people recognize their symptoms and know when to seek help.

In addition, train primary care physicians (such as general practitioners) to identify and treat mental disorders, since many people do not consult specialists. Also, improve the quality of available treatments, ensuring that people receive adequate and effective care.

In summary, the study highlights that there is still a long way to go to ensure that those suffering from mental disorders have access to treatment that really makes a difference.

READ MORE:

Effective Treatment for Mental and Substance Use Disorders in 21 Countries

Daniel V. Vigo,  Dan J. Stein,  Meredith G. Harris, Alan E. Kazdin, Maria Carmen Viana, Richard Munthali, Lonna Munro, Irving Hwang, Timothy L. Kessler, Sophie M. Manoukian, Nancy A. Sampson, Ronald C. Kessler, and the World Mental Health Survey

JAMA Psychiatry. Published online February 5, 2025. 

doi:10.1001/jamapsychiatry.2024.4378

Abstract:

Accurate baseline information about the proportion of people with mental disorders who receive effective treatment is required to assess the success of treatment quality improvement initiatives. To examine the proportion of mental and substance use disorders receiving guideline-consistent treatment in multiple countries. In this cross-sectional study, World Mental Health (WMH) surveys were administered to representative adult (aged 18 years and older) household samples in 21 countries. Data were collected between 2001 and 2019 and analyzed between February and July 2024. Twelve-month prevalence and treatment of 9 DSM-IV anxiety, mood, and substance use disorders were assessed with the Composite International Diagnostic Interview. Effective treatment and its components were estimated with cross-tabulations. Multilevel regression models were used to examine predictors. The main outcome was proportion of effective treatment received, defined at the disorder level using information about disorder severity and published treatment guidelines regarding adequate medication type, control, and adherence and adequate psychotherapy frequency. Intermediate outcomes included perceived need for treatment, treatment contact separately in the presence and absence of perceived need, and minimally adequate treatment given contact. Individual-level predictors (multivariable disorder profile, sex, age, education, family income, marital status, employment status, and health insurance) and country-level predictors (treatment resources, health care spending, human development indicators, stigma, and discrimination) were traced through intervening outcomes. Among the 56 927 respondents (69.3% weighted average response rate), 32 829 (57.7%) were female; the median (IQR) age was 43 (31-57) years. The proportion of 12-month person-disorders receiving effective treatment was 6.9% (SE, 0.3). Low perceived need (46.5%; SE, 0.6), low treatment contact given perceived need (34.1%; SE, 1.0), and low effective treatment given minimally adequate treatment (47.0%; SE, 1.7) were the major barriers, but with substantial variation across disorders. Country-level general medical treatment resources were more important than mental health treatment resources. Other than for the multivariable disorder profile, which was associated with all intermediate outcomes, significant predictors were largely mediated by treatment contact. In addition to the gaps in treatment quality, these results highlight the importance of increasing perceived need, the largest barrier to effective treatment; the importance of training primary care treatment clinicians in recognition and treatment of mental disorders; the need to improve the continuum of care, especially from minimally adequate to effective treatment; and the importance of bridging the effective treatment gap for men and people with lower education.