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http://hdl.handle.net/2445/132004
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 Obaid Alonso, Jordi Benjet, Corina Bruffaerts, Ronny Chiu, W. T. Florescu, Silvia E. Girolamo, Giovanni de Gureje, Oye Haro Abad, Josep Maria He, Yanling Hu, Chenchung Karam, Elie Georges Kawakami, Norito Lee, Sing Lund, Crick Kovess-Masfety, Viviane Levinson, Daphna Navarro Mateu, Fernando Pennell, Beth-Ellen Sampson, Nancy A. Scott, Kate M. (Kate Margaret), 1960- Tachimori, Hisateru Have, Margreet Ten Viana, Maria Carmen Williams, D. R. Wojtyniak, Bogdan J. Zarkov, Zahari Kessler, Ronald C. Chatterji, Somnath Thornicroft, Graham |
Keywords: | Malalties mentals Enquestes Condicions econòmiques Limitació de l'esforç terapèutic Mental illness Surveys 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: https://doi.org/10.1017/S0033291717003336 |
It is part of: | Psychological Medicine, 2017, vol. 48, num. 9, p. 1560-1571 |
URI: | http://hdl.handle.net/2445/132004 |
Related resource: | https://doi.org/10.1017/S0033291717003336 |
ISSN: | 0033-2917 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
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