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New research published in JAMA Psychiatry estimates that globally, only 6.9% of people with mental health or substance-use disorders receive effective treatment for their disorders.
Researchers from the University of British Columbia and Harvard Medical School analyzed survey data from nearly 57,000 participants in 21 countries collected over a 19-year period, to provide the clearest picture yet of where people discontinue their path to effective treatment for nine common anxiety, mood and substance-use disorders.
The biggest barrier to effective treatment is a person not recognizing that they need it, the study showed. However, even patients who contact the health care system often do not receive effective treatment.
“This survey data has allowed us to create the only effective treatment indicator that exists for mental health and substance use,” said lead author Dr. Daniel Vigo, associate professor at UBC’s department of psychiatry and school of population and public health.
“Policy decisions and allocative decisions for funding should be guided by data, and this hasn’t always been the case in the realm of mental health and substance use.”
The World Health Organization-World Mental Health Surveys Initiative collects data on the prevalence, severity and treatment of mental disorders worldwide. This study focused on survey participants who met criteria for a disorder under the Diagnostic and Statistical Manual of Mental Disorders-IV, a standardized classification system used by mental health professionals from 1994 to 2013.
The team, led by Dr. Vigo and Dr. Ronald Kessler of Harvard, was interested in how close participants got to receiving effective treatment that met evidence-based guidelines—and where they might have dropped off along the way.
They analyzed four key steps, and the percentage of people who proceeded from each step to the next:
Recognizes their need for treatment
Makes contact with the health care system about it
Receives a minimum level of adequate treatment
Receives effective treatment
They found:
Only 46.5% of people who met the criteria for a disorder recognized their need for treatment.
Of those who did recognize their need, only 34.1% turned to the medical system for help.
Most who sought help (82.9%) received a minimum level of adequate treatment.
About 47% of people who received minimally adequate treatment ended up receiving effective treatment.
Attrition at various points along this pathway meant that only 6.9% ended up receiving effective treatment.
“Understanding where the bottlenecks are for each of these disorders provides a unique and previously unavailable blueprint for decision makers to understand problems objectively and try to adjust the system,” said Dr. Vigo.
The study revealed a significant drop-off after patients contacted the health care system but before they received effective treatment. Since general practitioners and family doctors are typically their first point of contact with the system, it’s essential to make sure those doctors have appropriate training, said Dr. Vigo.
“Improving the ability of these general practitioners and family doctors to diagnose and treat the mild to moderate forms, and to know when to refer more severely affected folks to specialists, becomes the cornerstone of the system,” he said.
The research provides decision makers with a base of evidence to guide policy and funding decisions in mental health and substance use.
By highlighting gaps in service needs and outcomes for disorders ranging from bipolar disorders to addiction, it identifies where targeted investments could potentially yield the greatest impact. Armed with these insights, policymakers worldwide can prioritize interventions that result in improvements in care.
More information:
Effective Treatment for Mental and Substance Use Disorders in 21 Countries, JAMA Psychiatry (2025). DOI: 10.1001/jamapsychiatry.2024.4378
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University of British Columbia
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Only 7 out of 100 people receive effective treatment for mental health or substance-use disorders, large study finds (2025, February 5)
retrieved 5 February 2025
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