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Cited by 421Mental Health Treatment and AccessPsychiatric care and mental health servicesPsychology and Mental Health

Shortfall in mental health service utilisation

Open access
Andrews, Gavin, Issakidis, Cathy, Carter, Greg·2001·British Journal of Psychiatry
DOI 10.1192/bjp.179.5.417
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Abstract

Background: Treatment coverage for mental disorders is poor in most developed countries. Aims: To explore some reasons for the poor treatment coverage for mental disorders in developed countries. Method: Data were taken from Australian national surveys and from the World Health Report. Results: Only one-third of people with a mental disorder consulted. Probability of consulting varied by diagnosis: 90% for schizophrenia, which is accounted for by external factors; 60% for depression; and 15% for substance use and personality disorders. The probability of consulting varied by gender, age, marital status and disability, from 73% among women aged 25–54 years, disabled and once married to 9% among males without these risk factors. Those who did not consult but were disabled or comorbid said that they “preferred to manage themselves”. Data from five countries showed no evidence that overall health expenditure, out-of-pocket cost or responsiveness of the health system affected the overall consulting rates. Conclusions: Societal, attitudinal and diagnostic variables account for the variation. Funding does not. Public education about the recognition and treatment of mental disorders and the provision of effective treatment by providers might remedy the shortfall.

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  • Among people with anxiety disorders who seek help from a mental health professional, only 21.3% receive cognitive behavioral therapy.

    “However, only 16.7% of people who suffer from anxiety disorders seek help from a mental health professional, and of these individuals, only 21.3% receive CBT, which is arguably the most effective treatment [8].”

    From Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial. (2014) · cites this paper as [8]

    Table 3 reports that 16.7% of people with a current anxiety disorder consulted a mental health professional and that 21.3% of those who sought help received cognitive–behavioural therapy. But Table 3, footnote 7 defines the denominator for the therapy figure as people who consulted any health professional for a mental health problem, not just a mental health professional. (LLM, conf=0.94)

    Experimental — accuracy not yet measured

  • Many people with depression or anxiety disorders do not seek professional help.

    “Despite the severity of these consequences, it is estimated that up to one-half of those with depression [16-18] and only one third to one-half of those affected by anxiety disorders [8,16] seek professional help.”

    From A systematic review of help-seeking interventions for depression, anxiety and general psychological distress (2012) · cites this paper as [8]

  • Among people who suffer from anxiety disorders, only 16.7% seek help from a mental health professional.

    “However, only 16.7% of people who suffer from anxiety disorders seek help from a mental health professional, and of these individuals, only 21.3% receive CBT, which is arguably the most effective treatment [8].”

    From Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial. (2014) · cites this paper as [8]

  • Only 35% of young people experiencing mental health problems seek professional face-to-face help [91,92].

    “Only 35% of young people experiencing mental health problems seek professional face-to-face help [91,92].”

    From Do online mental health services improve help-seeking for young people? A systematic review (2014) · cites this paper as [92]

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  1. Includes help with finances, housing and welfare, as well as social support. https://doi.org/10.1192/bjp.179.5.417 Published online by Cambridge University Press REFERENCES REFERENCES

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Authors
Andrews, G., Issakidis, C., & Carter, G.
Affiliations
UNSW Sydney (AU)
Corresponding author
Andrews, Gavin
ORCID
Andrews, Gavin
Venue
British Journal of Psychiatry
Publisher
Royal College of Psychiatrists
Published
2001-11
Volume
179
Issue
5
Pages
417-425
ISSN
  • 0007-1250 (ISSN-L)
  • 1472-1465
DOI
10.1192/bjp.179.5.417
OpenAlex
W2082102545
Cited by
420
References
27
Citations by year
2026: 5 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 17 · 2021: 20 · 2020: 16 · 2019: 15 · 2018: 20 · 2017: 18 · 2016: 19 · 2015: 23 · 2014: 33 · 2013: 25 · 2012: 24
FWCI
13.69
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified, 5906 d)
Locations
  • The British Journal of Psychiatry (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
mental health service utilization, treatment coverage, help-seeking, mental illness, schizophrenia, depression, substance use disorders, personality disorders, gender differences, disability, comorbidities, self-management, health care costs, out-of-pocket costs, health system responsiveness, mental health funding, public education
MeSH terms
Adolescent, Adult, Aged, Attitude to Health, Australia, Mental Disorders, Female, Humans, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Perception, Regression Analysis, Sex Factors, Socioeconomic Factors, Odds Ratio

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