CoChat
Sign Up
Cited by 556Mental Health Treatment and AccessPsychiatric care and mental health servicesTreatment of Major Depression

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

Open access
Jorm, Anthony F., Patten, Scott B., Brugha, Traolach S., Mojtabai, Ramin·2017·World Psychiatry
DOI 10.1002/wps.20388PMC PMC5269479
Open this paper in CoChat — free accountOpen PDF

Abstract

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.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/wps.20388

Cites

91 of 91 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • At the global level, there are substantial shortages in access to mental health services and in resources allocated for their scale-up, as well as barriers to care such as perceived need for care and stigma.

    “However, at the global level, there are substantial shortages in access to these services, and in the resources allocated for their scale-up, as well as various barriers to care such as perceived need for care and stigma surrounding mental health problems.27, 28”

    From Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. (2022) · cites this paper as [27]

    The opening passage reports substantial treatment gaps across countries, and the England section notes research on stigma and under-use of treatment. The paper does not establish a global shortage of resources for scaling up services or identify perceived need for care as a barrier; its Conclusions discuss resource allocation to prevention instead. The cited passages have no page numbers in our copy. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Even in patients who respond well to traditional treatments, some continue to experience residual symptoms and/or risk of future relapse.

    “Furthermore, even in those who respond well to traditional treatments, some continue to experience residual symptoms, and/or a risk of future relapse [35,36,38].”

    From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [36]

    The United States section (page not specified in our copy) says that some people using treatment are in remission or partial remission and that continued treatment may be justified to prevent relapse. It does not establish that these are patients who responded well to traditional treatments, so that qualifier is unsupported. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Pharmacological and psychotherapeutic approaches do not result in full remission in all patients with mental disorders.

    “whilst the pharmacological [35,36] and psychotherapeutic approaches [37,38] are helpful for many, they do not result in full remission in all patients.”

    From Exercise as Medicine for Mental and Substance Use Disorders: A Meta-review of the Benefits for Neuropsychiatric and Cognitive Outcomes (2020) · cites this paper as [36]

    The Conclusions say pharmacological and psychological treatments for common mental disorders work, and the United States section notes that some antidepressant users were in partial rather than full remission. The paper does not establish patient-level remission outcomes for both approaches across mental disorders; its main finding concerns population prevalence. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • There has been an explicit call to quantify changes in mental health services utilization and treated prevalence of mental disorders across countries.

    “there has been an explicit call to quantify changes in mental health services utilization and treated prevalence of mental disorders across countries [27].”

    From Trends in psychiatric diagnoses, medications and psychological therapies in a large Swedish region: A population-based study (2020) · cites this paper as [27]

    The Conclusions (p. 99) explicitly call for future work to quantify changes in services and the prevalence of mental disorders across countries. The call does not specify *treated* prevalence; it refers to the prevalence of mental disorders generally. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • These models have historically performed poorly in predicting the population health effect of scaling up investment in mental health.

    “which have historically performed poorly in predicting the population health effect of scaling up investment in mental health. 469”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [469]

    The Conclusions (pp. 90–99) say that modelling predicted measurable reductions from closing the treatment gap, but that this modelling now appears optimistic. The review found no reduction in disorder prevalence despite increased treatment provision in four countries. It does not assess models of mental-health investment more broadly or establish a general history of poor model performance. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [56]56. Baker RP, Bradburn NM, Johnson RA. Computer-assisted personal inter- viewing: an experimental evaluation of data quality and cost. J Off Stat 1995;11:413-31.
  2. [67]67. Patten SB, Williams JVA, Lavorato D et al. Descriptive epidemiology of major depression in Canada in 2012. Can J Psychiatry 2014;60:23-30.
  3. [84]84. National Mental Health Commission. The national review of mental health programmes and services. Sydney: National Mental Health Com- mission, 2014.
  4. [89]89. Baxter AJ, Scott KM, Ferrari AJ et al. Challenging the myth of an "epidemic" of common mental disorders: trends in the global prevalence of anxiety and depression between 1990 and 2010. Depress Anxiety 2014; 31:506-16.

Cited by

Sorted by citations

Related

Authors
Jorm, A. F., Patten, S. B., Brugha, T. S., & Mojtabai, R.
Affiliations
  • The University of Melbourne (AU)
  • University of Calgary (CA)
  • University of Leicester (GB)
  • Johns Hopkins University (US)
ORCID
Venue
World Psychiatry
Publisher
Wiley
Published
2017-01-26
Volume
16
Issue
1
Pages
90-99
ISSN
  • 1723-8617 (ISSN-L)
  • 2051-5545
DOI
10.1002/wps.20388
PMC
PMC5269479
OpenAlex
W2582112541
Semantic Scholar
0a185104546fdaadffdb846867b3e270bcccf138
Cited by
556
References
91
Citations by year
2026: 40 · 2025: 65 · 2024: 72 · 2023: 70 · 2022: 61 · 2021: 68 · 2020: 67 · 2019: 60 · 2018: 37 · 2017: 16
FWCI
70.45
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • World Psychiatry (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
Funders
  • Alberta Innovates
  • Medical Research Council
  • National Health and Medical Research Council
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
common mental disorders, treatment gap, prevalence trends, mood disorders, anxiety disorders, antidepressant use, mental health care quality, mental health prevention, symptom underreporting, public awareness, mental health service delivery, Australia, Canada, England, United States

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review