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Cited by 249Mental Health Treatment and AccessPsychiatric care and mental health servicesPsychology and Mental Health

Delays in Initial Treatment Contact after First Onset of a Mental Disorder

Open access
Wang, Philip S., Berglund, Patricia A., Olfson, Mark, Kessler, Ronald C.·2004·Health Services Research
DOI 10.1111/j.1475-6773.2004.00234.xPMC PMC1361014
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Abstract

Objective. To examine nationally representative patterns and predictors of delays in contacting a professional after first onset of a mental disorder. Data Sources. The National Comorbidity Survey, a nationally representative survey of 8,098 respondents aged 15–54. Study Design. Cross‐sectional survey. Data Collection. Assessed lifetime DSM‐III‐R mental disorders using a modified version of the Composite International Diagnostic Interview (CIDI). Obtained reports on age at onset of disorders and age of first treatment contact with each of six types of professionals (general medical doctors, psychiatrists, other mental health specialists, religious professionals, human services professionals, and alternative treatment professionals). Used Kaplan–Meier (KM) curves to estimate cumulative lifetime probabilities of treatment contact after first onset of a mental disorder. Used survival analysis to study the predictors of delays in making treatment contact. Principal Findings. The vast majority (80.1 percent) of people with a lifetime DSM‐III‐R disorder eventually make treatment contact, although delays average more than a decade. The duration of delay is related to less serious disorders, younger age at onset, and older age at interview. There is no evidence that delay in initial contact with a health care professional is increased by earlier contact with other non–health‐care professionals. Conclusions. Within the limits of recalling lifetime events, it appears that delays in initial treatment contact are an important component of the larger problem of unmet need for mental health care. Interventions are needed to decrease these delays.

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  • The demand for mental health services far exceeds the available human resources able to meet this need in high-income and low-income and middle-income countries, including ever-growing treatment gaps and lags.

    “Unfortunately, the demand for mental health services far exceeds the available human resources able to meet this need in high-income and low-income and middle-income countries. This includes ever-growing treatment gaps2 and lags.3”

    From A novel ACT-based video game to support mental health through embedded learning: A mixed-methods feasibility study protocol (2020) · cites this paper as [3]

    Citation 3 is attached to the claim about treatment lags. The paper reports substantial delays in initial treatment contact, including an average of five years for the most severe cases. It does not support describing those lags as ever-growing; its discussion says delays are shorter in the youngest age cohorts. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. [32]32. Kendler, K. S., T. J. Gallagher, J. M. Abelson, and R. C. Kessler. 1996. ''Lifetime Prevalence, Demographic Risk Factors, and Diagnostic Validity of Nonaffective Psychosis as Assessed in a U.S. Community Sample.'' Archives of General Psychiatry 53 (11): 1022-31.
  2. [51]51. Lincoln, C. V., and P. McGorry. 1995. ''Who Cares?'' Psychiatric Services 46 (11): 1166- 71.

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Authors
Wang, P. S., Berglund, P. A., Olfson, M., & Kessler, R. C.
Affiliations
  • Brigham and Women's Hospital (US)
  • Harvard University (US)
Corresponding author
Wang, Philip S.
ORCID
Venue
Health Services Research
Publisher
Wiley
Published
2004-02-20
Volume
39
Issue
2
Pages
393-416
ISSN
  • 0017-9124 (ISSN-L)
  • 1475-6773
DOI
10.1111/j.1475-6773.2004.00234.x
PMC
PMC1361014
OpenAlex
W2154868042
Cited by
249
References
80
Citations by year
2026: 12 · 2025: 19 · 2024: 18 · 2023: 17 · 2022: 19 · 2021: 23 · 2020: 18 · 2019: 10 · 2018: 14 · 2017: 10 · 2016: 11 · 2015: 4 · 2014: 13 · 2013: 8 · 2012: 6
FWCI
8.79
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Health Services Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
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 › Psychology and Mental Health
Keywords
treatment delay, mental illness, help-seeking, mental health service utilization, unmet mental health needs, age of onset, National Comorbidity Survey
MeSH terms
Adolescent, Adult, Mental Disorders, Cross-Sectional Studies, Female, Health Services Needs and Demand, Health Services Research, Humans, Male, Middle Aged, Time Factors, United States, Diagnostic and Statistical Manual of Mental Disorders

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