Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys
Open accessAbstract
Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12-month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality ("minimally adequate treatment"). Among the 70,880 participants, 2.6% met 12-month criteria for substance use disorders; the prevalence was higher in upper-middle income (3.3%) than in high-income (2.6%) and low/lower-middle income (2.0%) countries. Overall, 39.1% of those with 12-month substance use disorders recognized a treatment need; this recognition was more common in high-income (43.1%) than in upper-middle (35.6%) and low/lower-middle income (31.5%) countries. Among those who recognized treatment need, 61.3% made at least one visit to a service provider, and 29.5% of the latter received minimally adequate treatment exposure (35.3% in high, 20.3% in upper-middle, and 8.6% in low/lower-middle income countries). Overall, only 7.1% of those with past-year substance use disorders received minimally adequate treatment: 10.3% in high income, 4.3% in upper-middle income and 1.0% in low/lower-middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate treatment. At least three barriers are involved: awareness/perceived treatment need, accessing treatment once a need is recognized, and compliance (on the part of both provider and client) to obtain adequate treatment. Various factors are likely to be involved in each of these three barriers, all of which need to be addressed to improve treatment coverage of substance use disorders. These data provide a baseline for the global monitoring of progress of treatment coverage for these disorders as an indicator within the SDGs.
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A much smaller proportion of people with mental health conditions access adequate care and support.
“A much smaller proportion access adequate care and support.(1-3)”
From The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review (2022) · cites this paper as [2]
The Results report that only 5.2% of people with substance use disorders received minimally adequate treatment in the past year. This supports the point about low access to adequate care for that group, but the paper does not establish the proportion for mental health conditions generally or for broader forms of support. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAround 40-60% of people with mental health conditions perceive a need for treatment but are not able to access any care.
“Around 40-60% of people with mental health conditions perceive a need for treatment but are not able to access any care.(1-3)”
From The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review (2022) · cites this paper as [2]
The Results report that 65.7% of people with substance use disorders who perceived a treatment need had contact with a provider or self-help group, meaning 34.3% had no such contact—not 40–60% overall. The figure was 45.0% in low/lower-middle-income countries, implying 55.0% had no contact there. The paper studies substance use disorders, not mental health conditions generally. (LLM, conf=0.88)
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- Authors
- Degenhardt, L., Glantz, M., Evans‐Lacko, S., Sadikova, E., Sampson, N., Thornicroft, G., Aguilar‐Gaxiola, S., Al‐Hamzawi, A., Alonso, J., Helena Andrade, L., Bruffaerts, R., Bunting, B., Bromet, E. J., Miguel Caldas de Almeida, J., de Girolamo, G., Florescu, S., Gureje, O., Maria Haro, J., Huang, Y., Karam, A., Karam, E. G., Kiejna, A., Lee, S., Lepine, J., Levinson, D., Elena Medina‐Mora, M., Nakamura, Y., Navarro‐Mateu, F., Pennell, B., Posada‐Villa, J., Scott, K., Stein, D. J., ten Have, M., Torres, Y., Zarkov, Z., Chatterji, S., Kessler, R. C., & on behalf of the World Health Organization's World Mental Health Surveys collaborators
- Affiliations
- UNSW Sydney (AU)
- National Institutes of Health (US)
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London London UK
- Harvard University (US)
- King's College London (GB)
- UC Davis Health (US)
- College of Medicine Al‐Qadisiya University Diwaniya Governorate Iraq
- Universitat Pompeu Fabra (ES)
- Section of Psychiatric Epidemiology, Institute of Psychiatry, University of São Paulo Medical School São Paulo Brazil
- KU Leuven (BE)
- University of Ulster (GB)
- Stony Brook School (US)
- Chronic Diseases Research Center and Department of Mental Health Faculdade de Ciências Médicas, Universidade Nova de Lisboa Lisbon Portugal
- IRCCS S. Giovanni di Dio Fatebenefratelli Brescia Italy
- National School of Public Health, Management and Professional Development (RO)
- University College Hospital, Ibadan (NG)
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona Barcelona Spain
- Peking University (CN)
- Institute for Development, Research, Advocacy and Applied Care Beirut Lebanon
- University of Balamand (LB)
- Wroclaw Medical University (PL)
- Chinese University of Hong Kong (HK)
- Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR‐S 1144, Paris Diderot and Paris Descartes Universities Paris France
- Israel Ministry of Health (IL)
- National Institute of Psychiatry Ramón de la Fuente Mexico City Mexico
- Jichi Medical University (JP)
- Servicio Murciano de Salud (ES)
- University of Michigan (US)
- Universidad Colegio Mayor de Cundinamarca (CO)
- University of Otago (NZ)
- University of Cape Town (ZA)
- Netherlands Institute of Mental Health and Addiction Utrecht The Netherlands
- Universidad CES (CO)
- National Center of Public Health and Analyses (BG)
- World Health Organization (CH)
- ORCID
- Degenhardt, Louisa
- Glantz, Meyer
- Sadikova, Ekaterina
- Sampson, Nancy
- Thornicroft, Graham
- Aguilar‐Gaxiola, Sergio
- Alonso, Jordi
- Bruffaerts, Ronny
- Bunting, Brendan
- Bromet, Evelyn J.
- Florescu, Silvia
- Gureje, Oye
- Huang, Yueqin
- Karam, Elie G.
- Kiejna, Andrzej
- Nakamura, Yosikazu
- Navarro‐Mateu, Fernando
- Scott, Kate
- Stein, Dan J.
- Torres, Yolanda
- Zarkov, Zahari
- Chatterji, Somnath
- Kessler, Ronald C.
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2017-09-21
- Volume
- 16
- Issue
- 3
- Pages
- 299-307
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC5608813
- OpenAlex
- W2760464711
- Cited by
- 267
- References
- 38
- Citations by year
- 2026: 18 · 2025: 36 · 2024: 33 · 2023: 48 · 2022: 39 · 2021: 24 · 2020: 30 · 2019: 29 · 2018: 8 · 2017: 2
- FWCI
- 14.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Deep Blue (University of Michigan) (submittedVersion)
- Scopus (Elsevier) (submittedVersion)
- Funders
- World Health Organization
- National Institute of Mental Health (R01 MH070884)
- MacArthur Foundation
- Pfizer Foundation
- U.S. Public Health Service (R13‐MH066849, R01‐MH069864 and R01 DA016558)
- Fogarty International Center (R03‐TW006481)
- Pan American Health Organization
- Eli Lilly and Company
- GlaxoSmithKline
- Bristol-Myers Squibb
- Shire
- National Health and Medical Research Council (1081984, 1041472)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- substance use disorders, treatment coverage, alcoholism, drug use disorders, treatment seeking, treatment access, treatment quality, SDG 11, global prevalence, income level, barriers to treatment, World Mental Health Surveys, cross-national comparison, medication adherence
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