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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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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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