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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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“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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Health insurance and mental illness
Kumar, C., Bijal, A., Manjunatha, N., Gowda, M., Basavaraju, V., & Math, S. (2019) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_158_19 · Cited by 16
“[11] In another study, there was an inconsistent association between treatment seeking and other enabling factors such as being in employment or having good social support.[12]”
BackgroundSocioeconomic Stratification and Mental Disorder
Eaton, W. W., & Muntaner, C. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.016 · Cited by 18
Development of a Patient-Report Measure of Psychotherapy for Depression
Miranda, J. M., Hepner, K. A., Azocar, F., Greenwood, G., Ngo, V. K., & Burnam, M. A. (2009) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-009-0238-7 · Cited by 16
“Yet many depressed patients do not receive evidence-based psychotherapy (Wang et al. 2000; Young et al. 2001).”
BackgroundKaterndahl, D. A., & Ferrer, R. L. (2004) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v06n0401 · Cited by 16
Achieving Long-Term Optimal Outcomes in Geriatric Depression and Anxiety
Mulsant, B. H., Whyte, E. M., Lenze, E. J., Lotrich, F. E., Karp, J. F., Pollock, B. G., & Reynolds, C. F. (2003) · CNS Spectrums · doi:10.1017/s1092852900008257 · Cited by 16
Cook, J. Α., Toprac, M. G., & Shore, S. E. (2004) · Psychiatric Rehabilitation Journal · doi:10.2975/27.2004.307.318 · Cited by 16
Lilienfeld, S. O., Ritschel, L. A., Lynn, S. J., Cautin, R. L., & Latzman, R. D. (2015) · Wiley eBooks · doi:10.1002/9781118625392.wbecp566 · Cited by 16
Carbone, J. T. (2020) · SSM - Population Health · doi:10.1016/j.ssmph.2020.100638 · Cited by 16
Steele, L. S., Glazier, R. H., Agha, M., & Moineddin, R. (2009) · Healthcare policy · doi:10.12927/hcpol.2009.20683 · Cited by 15
“There is good evidence that individuals from lower education areas have higher rates of mental health problems and so have a greater need for mental health services than individuals from higher education areas (Lorant et al. 2003; Muntaner et al. 2004; Wang et al. 2000).”
BackgroundMethodInfluentialEvidence-based treatments for anxiety and depression: lost in translation?
Unützer, J. (2008) · Depression and Anxiety · doi:10.1002/da.20529 · Cited by 13
“Research on the quality of care for depression and anxiety disorders continues to show large gaps between treatments that have been found to be efficacious in research trials and the care provided to typical patients with these problems in the real world.([2]) These gaps are best described for medication-based treatme…”
BackgroundKeith, V. M., & Brown, D. R. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.019 · Cited by 17
Understanding the Connection between Social Support and Mental Health
Brown, R. L., & Ciciurkaite, G. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289.014 · Cited by 15
Paranjape, A., Heron, S., Thompson, M. P., Bethea, K. S., Wallace, T. M., & Kaslow, N. J. (2007) · Women s Health Issues · doi:10.1016/j.whi.2006.08.004 · Cited by 15
Urbanoski, K. A., Rush, B. R., Wild, T. C., Bassani, D. G., & Castel, S. (2007) · Psychiatric Services · doi:10.1176/appi.ps.58.7.962 · Cited by 95
The Epidemiology of Worry and Generalized Anxiety Disorder
Holaway, R. M., Rodebaugh, T. L., & Heimberg, R. G. (2006) · Worry and its Psychological Disorders · doi:10.1002/9780470713143.ch1 · Cited by 42
Mental Health Care Models in Low-and Middle-Income Countries
Nadkarni, A., Hanlon, C., & Patel, V. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_156-1 · Cited by 16
Public Health Perspectives on Depressive Disorders
Cohen, N. L. (2017) · Johns Hopkins University Press eBooks · doi:10.1353/book.52762 · Cited by 15
Metadata
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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