Year: 2007
Type: article
Abstract: CONTEXT: Epidemiologic surveys have consistently found that approximately half of respondents who obtained treatment for mental or substance use disorders in the year before interview did not meet the criteria for any of the disorders assessed in the survey. Concerns have been raised that this pattern might represent evidence of misallocation of treatment resources. OBJECTIVE: To examine patterns and correlates of 12-month treatment of mental health or substance use problems among people who do not have a 12-month DSM-IV disorder. DESIGN AND SETTING: Data are from the National Comorbidity Survey Replication, a nationally representative face-to-face US household survey performed between February 5, 2001, and April 7, 2003, that assessed DSM-IV disorders using a fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI). PARTICIPANTS: A total of 5692 English-speaking respondents 18 years and older. MAIN OUTCOME MEASURES: Patterns of 12-month service use among respondents without any 12-month DSM-IV CIDI disorders. RESULTS: Of respondents who used 12-month services, 61.2% had a 12-month DSM-IV CIDI diagnosis, 21.1% had a lifetime but not a 12-month diagnosis, and 9.7% had some other indicator of possible need for treatment (subthreshold 12-month disorder, serious 12-month stressor, or lifetime hospitalization). The remaining 8.0% of service users accounted for only 5.6% of all services and even lower proportions of specialty (1.9%-2.4%) and general medical (3.7%) visits compared with higher proportions of human services (18.9%) and complementary and alternative medicine (7.6%) visits. Only 26.5% of the services provided to the 8.0% of presumably low-need patients were delivered in the mental health specialty or general medical sectors. CONCLUSIONS: Most services provided for emotional or substance use problems in the United States go to people with a 12-month diagnosis or other indicators of need. Patients who lack these indicators of need receive care largely outside the formal health care system.
Source: Archives of General Psychiatry
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: bronze
Funders: John D. and Catherine T. MacArthur Foundation, John W. Alden Trust, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, GlaxoSmithKline, Cisco Systems, National Institutes of Health, Pfizer Foundation, Pan American Health Organization, National Institute of Mental Health, National Institute on Drug Abuse, Fogarty International Center
Awards: G1037158725, World Mental Health Consortium Annual Meeting 2003-07, G1550703150, G1653309287, G2237026874, Social Role Disability and Mental-Physical Co-Morbidity, Drug Dependence Epidemiology and Enviromics, G2412493501, G33223526, CROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000, G3658001182, G3715573254, G4076321871, G4343067671, G4504230253, Risk Factors for Psychopathology in the WHO WMH Surveys, World Mental Health Consortium Annual Meetings 2008-2012, G6667095330, Epidemiology - National Comorbidity Survey Replication, G7284921876, G7433974870, G851565850, Lebanon-Epidemiology: The NCS Replication Study, G8808417261, G98479271
OpenAlex ID: W2060555702