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Title: Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: results from the WHO World Mental Health (WMH) surveys
Author: Evans Lacko, Sara
Aguilar Gaxiola, Sergio
Al-Hamzawi, Ali O.
Alonso, Jordi
Benjet, Corina
Bruffaerts, Ronny
Chiu, W. T.
Florescu, S.
Girolamo, Giovanni de
Gureje, Oye
Haro Abad, Josep Maria
He, Y.
Hu, Chenchung
Karam, Elie Georges
Kawakami, Norito
Lee, Sing
Lund, Crick
Kovess Masfet, V.
Levinson, Daphna
Navarro Mateu, Fernando
Pennell, B. E.
Sampson, N. A.
Scott, K. M.
Tachimori, H.
Ten Have, Margreet
Viana, Maria Carmen
Williams, D. R.
Wojtyniak, B. J.
Zarkov, Zahari
Kessler, Ronald C.
Chatterji, Somnath
Thornicroft, G.
Keywords: Malalties mentals
Condicions econòmiques
Limitació de l'esforç terapèutic
Mental illness
Economic conditions
Withholding treatment
Issue Date: Nov-2017
Publisher: Cambridge University Press
Abstract: Abstract BACKGROUND: The treatment gap between the number of people with mental disorders and the number treated represents a major public health challenge. We examine this gap by socio-economic status (SES; indicated by family income and respondent education) and service sector in a cross-national analysis of community epidemiological survey data. METHODS: Data come from 16 753 respondents with 12-month DSM-IV disorders from community surveys in 25 countries in the WHO World Mental Health Survey Initiative. DSM-IV anxiety, mood, or substance disorders and treatment of these disorders were assessed with the WHO Composite International Diagnostic Interview (CIDI). RESULTS: Only 13.7% of 12-month DSM-IV/CIDI cases in lower-middle-income countries, 22.0% in upper-middle-income countries, and 36.8% in high-income countries received treatment. Highest-SES respondents were somewhat more likely to receive treatment, but this was true mostly for specialty mental health treatment, where the association was positive with education (highest treatment among respondents with the highest education and a weak association of education with treatment among other respondents) but non-monotonic with income (somewhat lower treatment rates among middle-income respondents and equivalent among those with high and low incomes). CONCLUSIONS: The modest, but nonetheless stronger, an association of education than income with treatment raises questions about a financial barriers interpretation of the inverse association of SES with treatment, although future within-country analyses that consider contextual factors might document other important specifications. While beyond the scope of this report, such an expanded analysis could have important implications for designing interventions aimed at increasing mental disorder treatment among socio-economically disadvantaged people.
Note: Versió postprint del document publicat a:
It is part of: Psychological Medicine, 2017, vol. 48, num. 9, p. 1560-1571
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ISSN: 0033-2917
Appears in Collections:Articles publicats en revistes (Medicina)

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