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Delays in Initial Treatment Contact after First Onset of a Mental Disorder
Open accessAbstract
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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“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”
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Metadata
- 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.
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2004-02-20
- Volume
- 39
- Issue
- 2
- Pages
- 393-416
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- 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
- bronze
- doi.org
- Locations
- Health Services Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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 › 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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