Recent care of common mental disorders in the united states: Prevalence and conformance with evidence-based recommendations
Open accessAbstract
Objective To relate the presence of recent mental disorders to use of mental health services.Design Cross-sectional survey.Study population The study population was 3,032 respondents to the Midlife Development in the United States (MIDUS) survey, a nationally representative telephone-and-mail survey conducted in 1996. Twelve-month diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders, Revised, Third Edition, of major depressive episode, panic disorder, generalized anxiety disorder, and serious mental illness were made using a structured assessment. Information was obtained on 12-month treatment for mental health problems in the general medical, mental health specialty, human services, and self-help sectors. Definitions of treatments consistent with evidence-based recommendations were developed using available practice guidelines.Measurements and main results Crude and adjusted likelihoods of receiving any mental health care and guideline-concordant care were measured. Although 53. 8% of respondents with at least one 12-month mental disorder received any mental health care in the previous year, only 14.3% received care that could be considered consistent with evidence-based treatment recommendations. Even among those with the most serious and impairing mental illness, only 25% received guideline-concordant treatment. Predictors of receiving guideline-concordant care included being white, female, severely ill, and having mental health insurance coverage.Conclusions An epidemic of untreated and poorly treated mental disorders exists in the United States, especially among vulnerable groups such as African Americans and the underinsured. Cost-effective interventions are needed to improve both access to and quality of treatment.
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There is wide variation in the use of evidence-based treatments in usual care.
“An implementation research grant should cite service system research that demonstrates unmet need [15], the wide variation in the use of evidence-based treatments in usual care [16-19], or the association between the burden of disease and variations in the use of guidelines [20].”
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Pedersen, E. R., & Paves, A. P. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.05.017 · Cited by 226 · see citing works
“Despite the prevalence of mental health disorders and clinically significant symptoms, young adults are unlikely to seek mental health care for such concerns (Wang et al., 2000; Eisenberg et al., 2007a; Wu et al., 2007).”
BackgroundGoldstrom, I. D., Campbell, J., Rogers, J. A., Lambert, D. B., Blacklow, B., Henderson, M. J., & Manderscheid, R. W. (2005) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-005-0019-x · Cited by 225 · see citing works
“…with serious mental illnesses (Kessler et al., 1997; Narrow, Regier, Rae, Manderscheid, & Locke, 1993; Regier et al., 1993; Snowden & Lieberman, 1993; Wang et al., 2000), yet only one focusing on the groups, rather than individual mental health consumers, as the unit of analysis (Emerick, 1989).”
BackgroundRacial and Ethnic Differences in the Mental Health Problems and Use of Mental Health Care
Harris, K. M., Edlund, M. J., & Larson, S. L. (2005) · Medical Care · doi:10.1097/01.mlr.0000170405.66264.23 · Cited by 224 · see citing works
Five-Year Impact of Quality Improvement for Depression
Wells, K. B., Sherbourne, C. D., Schoenbaum, M., Ettner, S. L., Duan, N., Miranda, J. M., Unützer, J., & Rubenstein, L. V. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.4.378 · Cited by 221 · see citing works
PTSD in Urban Primary Care: High Prevalence and Low Physician Recognition
Liebschutz, J., Saitz, R., Brower, V., Keane, T. M., Lloyd-Travaglini, C., Averbuch, T., & Samet, J. H. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0161-0 · Cited by 223 · see citing works
Improving Depression Care for Older, Minority Patients in Primary Care
Areán, P. A., Ayalon, L., Hunkeler, E. M., Lin, E. H. B., Tang, L., Harpole, L. H., Hendrie, H. C., Williams, J. W., & Unützer, J. (2005) · Medical Care · doi:10.1097/01.mlr.0000156852.09920.b1 · Cited by 222 · see citing works
Treating minority patients with depression and anxiety: What does the evidence tell us?
Schraufnagel, T. J., Wagner, A. W., Miranda, J., & Roy-Byrne, P. P. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2005.07.002 · Cited by 205 · see citing works
Research on Evidence-Based Practices: Future Directions in an Era of Recovery
Anthony, W. A., Rogers, E. S., & Farkas, M. D. (2003) · Community Mental Health Journal · doi:10.1023/a:1022601619482 · Cited by 208 · see citing works
Sertraline for Prevention of Depression Recurrence in Diabetes Mellitus
Lustman, P. J., Clouse, R. E., Nix, B. D., Freedland, K. E., Rubin, E. H., McGill, J. B., Williams, M. M., Gelenberg, A. J., Ciechanowski, P. S., & Hirsch, I. B. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.5.521 · Cited by 199 · see citing works
Integrating Mental Health and Primary Care
Thielke, S. M., Vannoy, S. D., & Unützer, J. (2007) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2007.05.007 · Cited by 202 · see citing works
Disparities in mental health service use of racial and ethnic minority elderly adults
Jimenez, D. E., Cook, B., Bartels, S. J., & Alegría, M. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12063 · Cited by 201 · see citing works
Stetler, C., & Miller, G. E. (2005) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.114.4.697 · Cited by 200 · see citing works
Childhood origins of adult health: a basis for life-course health policy
Forrest, C. B., & Riley, A. W. (2004) · Health Affairs · doi:10.1377/hlthaff.23.5.155 · Cited by 194 · see citing works
Parental Depression and Anxiety and Early Childhood Behavior Problems Across Family Types
Meadows, S. O., McLanahan, S., & Jeanne Brooks-gunn, B. (2007) · Journal of Marriage and the Family · doi:10.1111/j.1741-3737.2007.00439.x · Cited by 186 · see citing works
Writing implementation research grant proposals: ten key ingredients
Proctor, E. K., Powell, B. J., Baumann, A. A., Hamilton, A. M., & Santens, R. L. (2012) · Implementation Science · doi:10.1186/1748-5908-7-96 · Cited by 169 · see citing works
“that demonstrates unmet need [15], the wide variation in the use of evidence-based treatments in usual care [16-19], or the association between the burden of disease and variations in the use of guidelines [20].”
BackgroundA Review of Quantitative Studies of Adherence to Mental Health Clinical Practice Guidelines
Bauer, M. S. (2002) · Harvard Review of Psychiatry · doi:10.1080/10673220216217 · Cited by 191 · see citing works
Mackenzie, C. S., Pagura, J., & Sareen, J. (2010) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181dd1c06 · Cited by 183 · see citing works
Guidelines on treatment of perinatal depression with antidepressants: An international review
Molenaar, N. M., Kamperman, A. M., Boyce, P., & Bergink, V. (2018) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867418762057 · Cited by 156 · see citing works
“Australian & New Zealand Journal of Psychiatry, 52(4) will be treated by a general practitioner (Alonso et al., 2004; Bijl and Ravelli, 2000; Bushnell et al., 2006; KovessMasfety et al., 2007; Verhaak et al., 2009, 2012; Wang et al., 2000), who are instructed to use a stepped care management approach (Van Weel-Baumgar…”
BackgroundStigma and treatment delay in first-episode psychosis: a grounded theory study
Franz, L., Carter, T., Leiner, A. S., Bergner, E. M., Thompson, N. J., & Compton, M. T. (2010) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2009.00155.x · Cited by 159 · see citing works
“Research suggests that in the United States, racial and ethnic minorities tend to receive a lower quality of health care than non-minorities, even when access-related factors, such as patients’ insurance status and income, are controlled.(50) In the report entitled Mental Health: Culture, Race, and Ethnicity,(51) then…”
BackgroundStigma and the Acceptability of Depression Treatments Among African Americans and Whites
Givens, J. L., Katz, I. R., Bellamy, S. L., & Holmes, W. C. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0276-3 · Cited by 152 · see citing works
Oordt, M. S., Jobes, D. A., Fonseca, V. P., & Schmidt, S. (2009) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2009.39.1.21 · Cited by 154 · see citing works
Høifødt, R. S., Lillevoll, K. R., Griffiths, K. M., Wilsgaard, T., Eisemann, M., Waterloo, K., & Kolstrup, N. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2714 · Cited by 154 · see citing works
Barriers to Mental Health Care Access in an African American Population
Hines-Martin, V. P., Malone, M., Kim, S., & Brown-Piper, A. (2003) · Issues in Mental Health Nursing · doi:10.1080/01612840305281 · Cited by 152 · see citing works
Culturally Responsive Cognitive Behavioral Therapy for Ethnically Diverse Populations
Huey, S. J., Park, A. L., Galán, C. A., & Wang, C. X. (2023) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-080921-072750 · Cited by 160 · see citing works
Socioeconomic Status and Self-Reported Barriers to Mental Health Service Use
Steele, L., Dewa, C., & Lee, K. (2007) · The Canadian Journal of Psychiatry · doi:10.1177/070674370705200312 · Cited by 152 · see citing works
“Anxiety and affective disorders are more common in lower-education and lower-income groups.(3,4) However, Canadian data show higher rates of specialty mental health service use in individuals with high education levels—and smaller or no differences in service use rates by income level.”
BackgroundFann, J. R., Bombardier, C. H., Vannoy, S., Dyer, J., Ludman, E., Dikmen, S., Marshall, K., Barber, J., & Temkin, N. (2015) · Journal of Neurotrauma · doi:10.1089/neu.2014.3423 · Cited by 147 · see citing works
“23,28,31,32 33–37 Barriers for people with TBI include stigma; difficulty coordinating care for multiple medical and psychological problems; limited transportation (e.g., because of cost, distance, seizure disorder with inability to drive); avoidance of trauma-focused components of mental health…”
Critical Race Theory: Opportunities for Application in Social Work Practice and Policy
Kolivoski, K. M., Weaver, A., & Constance-Huggins, M. A. (2014) · Families in Society The Journal of Contemporary Social Services · doi:10.1606/1044-3894.2014.95.36 · Cited by 145 · see citing works
Humanistic and economic burden of generalized anxiety disorder in North America and Europe
Revicki, D. A., Travers, K., Wyrwich, K. W., Svedsäter, H., Locklear, J., Mattera, M. S., Sheehan, D. V., & Montgomery, S. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.11.014 · Cited by 172 · see citing works
Systemic Inflammation in Midlife: Race, Socioeconomic Status, and Perceived Discrimination
Štěpáníková, I., Bateman, L. B., & Oates, G. R. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.09.026 · Cited by 141 · see citing works
“Measures of generalized anxiety and depressed affect were based on Wang et al.(62) The generalized anxiety scale consists of ten items, for example: How often over the past 12 months were you restless because of your worry?; the scale totals items for whichmost days was chosen.”
MethodRaposo, S., Mackenzie, C. S., Henriksen, C. A., & Afifi, T. O. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2013.04.009 · Cited by 140 · see citing works
The relationship between purpose in life and depression and anxiety: A meta-analysis.
Boreham, I. D., & Schutte, N. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23576 · Cited by 139 · see citing works
Cognitive-behavioral therapy for the treatment of anxiety disorders.
Otto, M. W., Smits, J. A. J., & Reese, H. E. (2004) · PubMed · Cited by 136 · see citing works
A Brief Motivational Intervention for Treatment‐Refusing OCD Patients
Maltby, N., & Tolin, D. F. (2005) · Cognitive Behaviour Therapy · doi:10.1080/16506070510043741 · Cited by 139 · see citing works
“Similarly, in a recent study of patients with major depression, generalized anxiety disorder, orpanicdisorder, only 27%ofpatients received the 8 or more psychotherapy sessions that would be concordant with established guidelines (Wang et al., 2000).”
BackgroundWittchen, H.-U., & Pittrow, D. (2002) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.398 · Cited by 188 · see citing works
Predictors of personal, perceived and self-stigma towards anxiety and depression
Grant, J. B., Bruce, C., & Batterham, P. J. (2015) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796015000220 · Cited by 138 · see citing works
“Previous research has identified a range of variables potentially associated with stigma, and has focused largely on stigma towards depression (as a common mental disorder (Wang et al. 2000)) and schizophrenia (as a less prevalent, but highly stigmatised disorder (Birchwood et al. 2006)).”
BackgroundConner, K. O., Copeland, V. C., Grote, N. K., Rosen, D., Albert, S. M., McMurray, M. L., Reynolds, C. F., Brown, C., & Koeske, G. F. (2010) · Aging & Mental Health · doi:10.1080/13607863.2010.501061 · Cited by 134 · see citing works
“In particular, African-American older adults with depression are less likely than their White counterparts to receive an appropriate diagnosis (Gallo, Cooper-Patrick, & Lesikar, 1998 ) or to receive empirically supported treatments for depression (Wang, Berglund, & Kessler, 2000 ; Young, Klap, & Sherbourne, 2001 ).”
BackgroundEvidence review: efficacy and effectiveness of antidepressant treatment in primary care
Simon, G. E. (2002) · General Hospital Psychiatry · doi:10.1016/s0163-8343(02)00198-6 · Cited by 132 · see citing works
Snowden, L. R. (2012) · American Psychologist · doi:10.1037/a0030054 · Cited by 133 · see citing works
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Steele, L., Dewa, C., Lin, E., & Lee, K. (2007) · Healthcare Policy | Politiques de Santé · doi:10.12927/hcpol.2007.19177 · Cited by 131 · see citing works
Higher Burden of Depression Among Older Women
Barry, L. C., Allore, H. G., Guo, Z., BRUCE, M. L., & Gill, T. M. (2008) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2007.17 · Cited by 130 · see citing works
Bridging Community Intervention and Mental Health Services Research
Wells, K., Miranda, J., Bruce, M. L., Alegria, M., & Wallerstein, N. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.6.955 · Cited by 237 · see citing works
Association of reports of childhood abuse and all-cause mortality rates in women
Chen, E., Turiano, N. A., Mroczek, D. K., & Miller, G. E. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.1786 · Cited by 128 · see citing works
Lederer, V., Loisel, P., Rivard, M., & Champagne, F. (2013) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-013-9459-4 · Cited by 127 · see citing works
Racial Differences in Beliefs About the Effectiveness and Necessity of Mental Health Treatment
Anglin, D. M., Alberti, P. M., Link, B. G., & Phelan, J. C. (2008) · American Journal of Community Psychology · doi:10.1007/s10464-008-9189-5 · Cited by 127 · see citing works
“…disparity have been offered in the literature and range from well-documented inequalities in the quality of care received (Smedly et al. 2003; Wang et al. 2000) and socioeconomic status (Muntaner 1999) to psychosocial explanations of cultural mistrust (Nickerson et al. 1994; Whaley 2001a,…”
BackgroundCorrelates of Sexual Activity and Satisfaction in Midlife and Older Women
Thomas, H. N., Hess, R., & Thurston, R. C. (2015) · The Annals of Family Medicine · doi:10.1370/afm.1820 · Cited by 127 · see citing works
- Authors
- Wang, P. S., Berglund, P., & Kessler, R. C.
- Affiliations
- Harvard University (US)
- University of Michigan (US)
- Venue
- Journal of General Internal Medicine
- Published
- 2000-05
- Volume
- 15
- Issue
- 5
- Pages
- 284-292
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC1495452
- OpenAlex
- W1972523301
- Cited by
- 686
- References
- 44
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 17 · 2023: 17 · 2022: 19 · 2021: 13 · 2020: 18 · 2019: 14 · 2018: 19 · 2017: 60 · 2016: 23 · 2015: 28 · 2014: 28 · 2013: 30 · 2012: 32
- FWCI
- 42.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- John D. and Catherine T. MacArthur Foundation
- National Institutes of Health (2k05mh000507-13)
- National Institute of Mental Health (K05 MH 00507, Z01MH000507)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- mental health service utilization, guideline-concordant care, evidence-based treatment, major depressive episode, panic disorder, generalized anxiety disorder, severe mental illness, mental health coverage, racial disparities, African Americans, underinsured, access to mental health care, mental health care quality, Midlife Development in the United States
- MeSH terms
- Adult, Aged, Anxiety Disorders, Cross-Sectional Studies, Depression, Female, Health Surveys, Humans, Male, Middle Aged, United States, Prevalence, Chi-Square Distribution, Likelihood Functions, Logistic Models, Panic Disorder, Evidence-Based Medicine, Guideline Adherence
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