Home LiteratureArticle Details
PMID: 11772769 Published · ppublish English Comparative Study Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Adequacy of treatment for serious mental illness in the United States.

American journal of public health ·Vol. 92 ·No. 1 ·2002-01-00 ·Pages 92-8

Wang PS, Demler O, Kessler RC

Abstract

The purpose of this study was to assess the prevalence and correlates of treatment for serious mental illness. Data were derived from the National Comorbidity Survey, a cross-sectional, nationally representative household survey assessing the presence and correlates of mental disorders and treatments. Crude and adjusted likelihoods of receiving treatment for serious mental illness in the previous 12 months were calculated. Forty percent of respondents with serious mental illness had received treatment in the previous year. Of those receiving treatment, 38.9% received care that could be considered at least minimally adequate, resulting in 15.3% of all respondents with serious mental illness receiving minimally adequate treatment. Predictors of not receiving minimally adequate treatment included being a young adult or an African American, residing in the South, being diagnosed as having a psychotic disorder, and being treated in the general medical sector. Inadequate treatment of serious mental illness is an enormous public health problem. Public policies and cost-effective interventions are needed to improve both access to treatment and quality of treatment.

MeSH Terms
Adolescent Adult African Americans Age Factors Anxiety Disorders/therapy Education Female Hispanic or Latino Humans Income Logistic Models Male Marital Status Mental Disorders/therapy Middle Aged Mood Disorders/therapy Multivariate Analysis Psychotic Disorders/therapy Public Health United States Whites
Authors & Affiliations
3 authors, click to expand affiliations / ORCID
Wang Philip S
Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA. [email protected]
Demler Olga
Kessler Ronald C
References (53)
53 references, click to expand
  1. Office visits to psychiatrists: United States, 1989-90.
    Adv Data. 1993 Dec 28;(237):1-16 PMID: 10131548
  2. Principles for priority setting in mental health services and their implications for the least well off.
    Psychiatr Serv. 1999 May;50(5):653-8 PMID: 10332901
  3. The obligation of mental health services to the least well off.
    Psychiatr Serv. 1999 May;50(5):659-63 PMID: 10332902
  4. Evidence of clozapine's effectiveness in schizophrenia: a systematic review and meta-analysis of randomized trials.
    Am J Psychiatry. 1999 Jul;156(7):990-9 PMID: 10401441
  5. Beyond screening: improving the quality of treatment for depression.
    Harv Rev Psychiatry. 1999 Sep-Oct;7(3):177-82 PMID: 10483937
  6. Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial.
    Arch Gen Psychiatry. 1999 Dec;56(12):1109-15 PMID: 10591288
  7. Impact of disseminating quality improvement programs for depression in managed primary care: a randomized controlled trial.
    JAMA. 2000 Jan 12;283(2):212-20 PMID: 10634337
  8. Recent care of common mental disorders in the United States : prevalence and conformance with evidence-based recommendations.
    J Gen Intern Med. 2000 May;15(5):284-92 PMID: 10840263
  9. Clinical services research.
    Schizophr Bull. 1992;18(4):561-626 PMID: 1439613
  10. Treating depression and anxiety in primary care. Closing the gap between knowledge and practice.
    N Engl J Med. 1992 Apr 16;326(16):1080-4 PMID: 1463479
  11. Community mental health and ethnic minority populations.
    Community Ment Health J. 1990 Jun;26(3):277-91 PMID: 2354624
  12. Mental health roles of physicians in a Mexican-American community.
    Community Ment Health J. 1969 Feb;5(1):62-9 PMID: 24178698
  13. Demand analysis of mental health service use among ethnic subpopulations.
    Inquiry. 1989 Summer;26(2):202-15 PMID: 2526089
  14. The NIMH Depression Awareness, Recognition, and Treatment Program: structure, aims, and scientific basis.
    Am J Psychiatry. 1988 Nov;145(11):1351-7 PMID: 2847566
  15. Factors affecting the utilization of specialty and general medical mental health services.
    Med Care. 1988 Jan;26(1):9-26 PMID: 3336249
  16. Why do schizophrenic patients refuse to take their drugs?
    Arch Gen Psychiatry. 1974 Jul;31(1):67-72 PMID: 4151750
  17. Perception of mental illness in a Mexican-American community.
    Arch Gen Psychiatry. 1969 Feb;20(2):233-8 PMID: 5763532
  18. Working class Mexican psychiatric outpatients. Some social and cultural features.
    Arch Gen Psychiatry. 1967 Jun;16(6):704-12 PMID: 6027369
  19. Mental health services providers' distribution across countries in the United States.
    Am Psychol. 1984 Dec;39(12):1424-34 PMID: 6524764
  20. Psychic distress, life crisis, and use of psychotherapeutic medications: national household survey data.
    Arch Gen Psychiatry. 1978 Sep;35(9):1045-52 PMID: 686968
  21. Pharmacotherapy of Hispanic depressed patients: clinical observations.
    Am J Psychother. 1982 Oct;36(4):505-12 PMID: 7158673
  22. Subjective response as a predictor of outcome in pharmacotherapy: the consumer has a point.
    Arch Gen Psychiatry. 1978 Apr;35(4):477-80 PMID: 727898
  23. An empirical typology of subjects within stage of change.
    Addict Behav. 1995 May-Jun;20(3):299-320 PMID: 7653313
  24. Collaborative management to achieve treatment guidelines. Impact on depression in primary care.
    JAMA. 1995 Apr 5;273(13):1026-31 PMID: 7897786
  25. Use of minor tranquilizers and antidepressant medications by depressed outpatients: results from the medical outcomes study.
    Am J Psychiatry. 1994 May;151(5):694-700 PMID: 7909411
  26. Demographic factors associated with extreme non-compliance in schizophrenia.
    Soc Psychiatry Psychiatr Epidemiol. 1994 Jul;29(4):172-7 PMID: 7939966
  27. APA issues practice guideline for major depressive disorder in adults. American Psychiatric Association.
    Am Fam Physician. 1993 Nov 15;48(7):1312-3 PMID: 8237743
  28. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.
    Arch Gen Psychiatry. 1994 Jan;51(1):8-19 PMID: 8279933
  29. Who should receive high-cost mental health treatment and for how long?
    Schizophr Bull. 1993;19(4):843-52 PMID: 8303231
  30. Health care reform for Americans with severe mental illnesses: report of the National Advisory Mental Health Council.
    Am J Psychiatry. 1993 Oct;150(10):1447-65 PMID: 8379547
  31. Use of services by persons with mental and addictive disorders. Findings from the National Institute of Mental Health Epidemiologic Catchment Area Program.
    Arch Gen Psychiatry. 1993 Feb;50(2):95-107 PMID: 8381266
  32. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services.
    Arch Gen Psychiatry. 1993 Feb;50(2):85-94 PMID: 8427558
  33. The roles of psychiatrists in organized outpatient mental health settings.
    Am J Psychiatry. 1993 Apr;150(4):625-31 PMID: 8465881
  34. Racial differences in the use of revascularization procedures after coronary angiography.
    JAMA. 1993 May 26;269(20):2642-6 PMID: 8487447
  35. Advances in strategies for minimizing and adjusting for survey nonresponse.
    Epidemiol Rev. 1995;17(1):192-204 PMID: 8521937
  36. Report of the Expert Panel on Awareness and Behavior Change to the Board of Directors, American Heart Association.
    Circulation. 1996 May 1;93(9):1768-72 PMID: 8653885
  37. A multifaceted intervention to improve treatment of depression in primary care.
    Arch Gen Psychiatry. 1996 Oct;53(10):924-32 PMID: 8857869
  38. Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey.
    Arch Gen Psychiatry. 1996 Nov;53(11):1022-31 PMID: 8911225
  39. Differences between detected and undetected patients in primary care and depressed psychiatric patients.
    Gen Hosp Psychiatry. 1996 Nov;18(6):407-15 PMID: 8937906
  40. The National Depressive and Manic-Depressive Association consensus statement on the undertreatment of depression.
    JAMA. 1997 Jan 22-29;277(4):333-40 PMID: 9002497
  41. Competing demands in psychosocial care. A model for the identification and treatment of depressive disorders in primary care.
    Gen Hosp Psychiatry. 1997 Mar;19(2):98-111 PMID: 9097064
  42. The epidemiology of DSM-III-R bipolar I disorder in a general population survey.
    Psychol Med. 1997 Sep;27(5):1079-89 PMID: 9300513
  43. Patterns and predictors of treatment contact after first onset of psychiatric disorders.
    Am J Psychiatry. 1998 Jan;155(1):62-9 PMID: 9433340
  44. Limitations of diagnostic criteria and assessment instruments for mental disorders. Implications for research and policy.
    Arch Gen Psychiatry. 1998 Feb;55(2):109-15 PMID: 9477922
  45. Diagnosis and need for treatment are not the same.
    Arch Gen Psychiatry. 1998 Feb;55(2):120 PMID: 9477924
  46. Medication management of depression in the United States and Ontario.
    J Gen Intern Med. 1998 Feb;13(2):77-85 PMID: 9502366
  47. Competing demands: Does care for depression fit in primary care?
    J Gen Intern Med. 1998 Feb;13(2):137-9 PMID: 9502376
  48. Translating research into practice: the Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations.
    Schizophr Bull. 1998;24(1):1-10 PMID: 9502542
  49. Patterns of usual care for schizophrenia: initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey.
    Schizophr Bull. 1998;24(1):11-20; discussion 20-32 PMID: 9502543
  50. Compliance with medication regimens for mental and physical disorders.
    Psychiatr Serv. 1998 Feb;49(2):196-201 PMID: 9575004
  51. Adolescents who drop out of psychotherapy at a community-based psychotherapy centre: a preliminary investigation of the characteristics of early drop-outs, late drop-outs and those who continue treatment.
    Br J Med Psychol. 1998 Sep;71 ( Pt 3):233-45 PMID: 9733419
  52. The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression.
    Arch Gen Psychiatry. 1998 Dec;55(12):1128-32 PMID: 9862557
  53. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials.
    Schizophr Res. 1999 Jan 4;35(1):51-68 PMID: 9988841
Article Info
Journal
American journal of public health
Abbr.
Am J Public Health
ISSN
0090-0036
DOI
10.2105/ajph.92.1.92
Email
[email protected]
Published
2002-01-00
Pages
92-8
Language
English
Region
United States
NLM ID
1254074
PMCID
PMC1447396
Subset
IM
Grants
NIMH NIH HHS · K01 MH 01651 · United States
NIMH NIH HHS · R01 MH 52861 · United States
NIMH NIH HHS · R01 MH046376 · United States
NIMH NIH HHS · R01 MH049098 · United States
NIMH NIH HHS · R01 MH 46376 · United States
NIMH NIH HHS · R01 MH 49098 · United States
NIMH NIH HHS · K05 MH 00507 · United States
External Links
PubMed source DOI: 10.2105/ajph.92.1.92 PMC Full Text View journal details
Analysis Services
Analysis Services

Contact

No. 2 Wenbo Road, Zhangqiu District, Jinan, Shandong

Qilu Normal University · Genelibs Bioinformatics Lab

750 Shunhua Rd, Jinan

2F, Bldg F, University Science Park

Tel: 0531-88819269

WeChat Official Account

Follow our WeChat subscription account for real-time updates and the latest in medical and biological research.


Business Email

E-mail: [email protected]

Copyright © 2026.Genelibs Jinan Honghui Biotechnology Co., Ltd. 鲁ICP备20007159号-2