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Treated and untreated prevalence of mental disorders: results from the World Health Organization World Mental Health (WMH) surveys1 

Treated and untreated prevalence of mental disorders: results from the World Health Organization World Mental Health (WMH) surveys1
Chapter:
Treated and untreated prevalence of mental disorders: results from the World Health Organization World Mental Health (WMH) surveys
Author(s):

Philip S. Wang

, Aguilar-Gaxiola Sergio

, Ali Obaid AlHamzawi

, Jordi Alonso

, Laura Helena Andrade

, Matthias C. Angermeyer

, Guilherme Borges

, Evelyn J. Bromet

, Ronny Bruffaerts

, Brendan Bunting

, José Miguel Caldas de Almeida

, Silvia Florescu

, Giovanni de Girolamo

, Ron de Graaf

, Oye Gureje

, Josep Maria Haro

, Hristo Ruskov Hinkov

, Chi-yi Hu

, Elie G. Karam

, Viviane Kovess

, Sing Lee

, Daphna Levinson

, Yutaka Ono

, Maria Petukhova

, José Posada-Villa

, Rajesh Sagar

, Soraya Seedat

, J. Elisabeth Wells

, and Ronald C. Kessler

DOI:
10.1093/med/9780199565498.003.0027
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date: 23 October 2019

Neuropsychiatric disorders are leading causes of disability worldwide, accounting for 37 % of all healthy life years lost from disease (Lopez et al., 2006). They are among the most disabling conditions even in low-income countries, where detection of emotional problems and access to treatment are lowest. Although efficacious and tolerable treatments for these disorders are increasingly available, even economically-advantaged societies experience competing priorities and budgetary constraints (Tasman et al., 2003). Knowing how to provide effective treatment is consequently a worldwide imperative (Hu, 2003). Unfortunately, most countries suffer from a lack of data to guide decisions, absent or competing visions for resources, and near constant pressures to cut insurance and entitlements (Mechanic, 1994).

How can countries redesign their mental health care systems and optimally allocate resources? A first step is to document the services currently being used as well as the extent and nature of unmet needs for treatment. A second step may be to conduct cross-national comparisons of service use and unmet needs in countries with different mental health care systems. Such comparisons have the potential to help uncover optimal financing, national policies, and delivery systems for the care of mental disorders. Unfortunately, few cross-national studies of such differences are available (Bijl et al., 2003; Kessler et al., 1997).

For these reasons, WHO established the WMH Survey Initiative in 1998 (Demyttenaere et al., 2004 ). Coordinated surveys of the prevalence of mental disorders, their severity, impairments, and treatments have been implemented and analysed in 24 developing and developed countries. The current report describes the levels, types, and adequacy of mental health service use in these countries. We also examine unmet needs for treatment among strata defined by the seriousness of mental disorders. Finally, we identify sociodemographic correlates of unmet needs for treatment to guide the design and targeting of future resources, policies, and interventions.

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