Cited by 781Mental Health Treatment and AccessHealth disparities and outcomesMigration, Health and Trauma

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index; 12 of the 25 sources its claims cite were checked for support.

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

Open access
Evans-Lacko, S., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Benjet, C., Bruffaerts, R., Chiu, W. T., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., He, Y., Hu, C., Karam, E. G., Kawakami, N., Lee, S., Lund, C., Kovess-Masfety, V., Levinson, D., Navarro-Mateu, F., Pennell, B. E., Sampson, N. A., Scott, K. M., Tachimori, H., ten Have, M., Viana, M. C., Williams, D. R., Wojtyniak, B. J., Zarkov, Z., Kessler, R. C., Chatterji, S., Thornicroft, G.·2018·Psychological Medicine

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. © 2017 Cambridge University Press.

Overview

Integrity signals

Registry

Crossref · 10.1017/s0033291717003336

Cites

36 of 36 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

50 Own result · 18 Own method · 8 Own interpretation · 7 No full text of the sources · 6 Partly supported · 3 Sources not found · 1 Supported · 1 Couldn’t confirm · accuracy not yet measured

Show all 40 claims

  • Probably not a substantial claim. 21
  • It may state two separate claims as one. 39
54 of 54
  • The authors state this as an assumption.

    For respondents with two disorders, the added predictive effect of each individual disorder is multiplicative.

    “The incremental predictive effects of individual disorders among people with 2 disorders were then assumed to be multiplicative; that is, if the OR associated with Disorder X was 1.5, we would expect respondents with exactly 1 other disorder would have a 1.5 increased odds of obtaining treatment in the presence versus absence of Disorder X.”
  • The authors state this as an assumption.

    The odds ratio for a given disorder is the same across all combinations of that disorder with exactly one other disorder.

    “This specification imposed parsimony on the data by constraining the OR of Disorder X to be the same across all 11 combinations of Disorder X with exactly l other disorder”
  • The authors state this as an assumption.

    The 3-way and higher-order interactions among disorders predicting treatment were subject to a constant multiplier that could be 1.0 or different from 1.0.

    “The dummy variables for 3 and 4+ disorders imposed additional constraints by assuming that the 3-way and higher-order interactions among disorders predicting treatment were subject to a constant multiplier that could be 1.0 (i.e., the interactions were strictly multiplicative) or different from 1.0.”
  • The authors state this as an assumption.

    The mechanisms by which income and education affect treatment are different.

    “We considered it appropriate to include both, though, as the mechanisms involved in the two are presumably different.”
4 of 4

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?

Self-check

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

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Show all 35 references

Research works printed but not linked: 6

  1. 2009, World Bank List of Economies (July 2009)
  2. 2002, SUDAAN: Professional Software for Survey Data Analysis [Computer Program]
  3. 2016, Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys
  4. First, 2002, Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-Patient Edition. (SCID-I/NP)
  5. Harkness, 2008, The WHO World Mental Health Surveys: Global Perspectives on the Epidemiology of Mental Disorders, 91
  6. 2012, Global Burden of Mental Disorders and the Need for A Comprehensive, Coordinated Response From Health and Social Sectors at the Country Level

Cited by

Sorted by citations

See all 781

Metadata

Authors
Evans-Lacko, S., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Benjet, C., Bruffaerts, R., Chiu, W. T., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., He, Y., Hu, C., Karam, E. G., Kawakami, N., Lee, S., Lund, C., Kovess-Masfety, V., Levinson, D., Navarro-Mateu, F., Pennell, B. E., Sampson, N. A., Scott, K. M., Tachimori, H., ten Have, M., Viana, M. C., Williams, D. R., Wojtyniak, B. J., Zarkov, Z., Kessler, R. C., Chatterji, S., & Thornicroft, G.
Affiliations
  • King's College London (GB)
  • University of Al-Qadisiyah (IQ)
  • Universitat Pompeu Fabra (ES)
  • Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
  • KU Leuven (BE)
  • Harvard University (US)
  • National School of Public Health, Management and Professional Development (RO)
  • University College Hospital, Ibadan (NG)
  • Centro de Investigación Biomédica en Red de Salud Mental (ES)
  • Shanghai Jiao Tong University (CN)
  • Shenzhen KangNing Hospital (CN)
  • University of Balamand (LB)
  • The University of Tokyo (JP)
  • Chinese University of Hong Kong (HK)
  • University of Cape Town (ZA)
  • Israel Ministry of Health (IL)
  • University of Michigan (US)
  • University of Otago (NZ)
  • National Center of Neurology and Psychiatry (JP)
  • Universidade Federal do Espírito Santo (BR)
  • Narodowy Instytut Zdrowia Publicznego PZH – Państwowy Instytut Badawczy (PL)
  • National Center of Public Health and Analyses (BG)
  • World Health Organization (CH)
Corresponding author
Kessler, R. C.
Venue
Psychological Medicine
Published
2017-11-27
Volume
48
Issue
9
Pages
1560-1571
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
OpenAlex
W2766194567
Cited by
781
References
35
Citations by year
2026: 110 · 2025: 164 · 2024: 179 · 2023: 145 · 2022: 123 · 2021: 26 · 2020: 18 · 2019: 10 · 2018: 4
FWCI
12.53
Type
journal article
Language
en
Open access
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (acceptedVersion)
  • London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
  • London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, public-domain)
  • Research Portal (King's College London) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion)
Funders
  • Robert Wood Johnson Foundation (044708, Grant 044708)
  • John D. and Catherine T. MacArthur Foundation (R01 DA016558, R13-MH066849)
  • John W. Alden Trust
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • World Health Organization
  • University of Michigan
  • South London and Maudsley NHS Foundation Trust
  • King's College Hospital NHS Foundation Trust
  • Universidad CES
  • National Institute for Health and Care Research (FP7/2007–2013)
  • King's College London
  • European Commission (EAHC 20081308, 20081308, 2007–2013, FP7 2007-2013, QLG5–1999-01042, SANCO2004123, 2004123, FP7/2007)
  • Public Health Agency
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (03/00204-3, 03/00204?)
  • Generalitat de Catalunya (01042)
  • Bundesministerium für Gesundheit
  • National Insurance Institute of Israel
  • Ministry of Health, Labour and Welfare (H25-SEISHIN-IPPAN-006, H13-SHOGAI-023)
  • Universidade de Lisboa
  • Ministerio de Ciencia y Tecnología (SAF 2000 158-CE)
  • Fundación para la Formación e Investigación Sanitarias de la Región de Murcia
  • Servicio Murciano de Salud
  • Regione Piemonte (00/0028)
  • Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu
  • Servier
  • H. Lundbeck A/S
  • Fundação Champalimaud (R01 MH070884)
  • Ministerio de Salud
  • Ministerstwo Zdrowia
  • National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
  • Substance Abuse and Mental Health Services Administration
  • U.S. Public Health Service (R01-DA016558, R13‐MH066849, R01- MH069864)
  • Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849, R03-TW006481)
  • Pan American Health Organization
  • Executive Agency for Health and Consumers
  • Fundação para a Ciência e a Tecnologia
  • Instituto de Salud Carlos III (CB06/02/0046, RETICS RD06/0011, RD06/0011, FIS 00/0028, CIBER CB06/02/0046)
  • Norway Grants
  • Consejería de Sanidad y Política Social, Comunidad Autónoma de la Región de Murcia
  • Departament de Salut, Generalitat de Catalunya
  • National Institute of Mental Health (R13-MH-066849, R01‐MH070884, R01MH061905, R01MH059575, MH60220, MH070884, U01MH060220, R01‐MH069864)
  • National Institute on Drug Abuse (R01DA016558)
  • Fogarty International Center (FIRCA R03TW006481, R03TW006481)
  • FP7 Ideas: European Research Council (337673)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
mental health treatment gap, socioeconomic status, anxiety disorders, mood disorders, substance use disorders, income, mental health services, financial barriers, low- and middle-income countries
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Developing Countries, Female, Health Surveys, Humans, Male, Mental Health, Middle Aged, Patient Acceptance of Health Care, Psychotherapy, Socioeconomic Factors, Multivariate Analysis, Logistic Models, Developed Countries, Internationality, Healthcare Disparities, Young Adult

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.

A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

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