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Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys

2025-02Artigo científico Acesso aberto
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dc.contributor.authorViana, Maria Carmen
dc.contributor.authorKazdin, Alan E.
dc.contributor.authorHarris, Meredith G.
dc.contributor.authorStein, Dan J.
dc.contributor.authorVigo, Daniel V.
dc.contributor.authorHwang, Irving
dc.contributor.authorManoukian, Sophie M.
dc.contributor.authorSampson, Nancy A.
dc.contributor.authorAlonso, Jordi
dc.contributor.authorAndrade, Laura Helena
dc.contributor.authorBorges, Guilherme
dc.contributor.authorBunting, Brendan
dc.contributor.authorde Girolamo, Giovanni
dc.contributor.authorJonge, Peter de
dc.contributor.authorGureje, Oye
dc.contributor.authorHaro, Josep Maria
dc.contributor.authorKaram, Elie G.
dc.contributor.authorKovess-Masfety, Viviane
dc.contributor.authorMoskalewicz, Jacek
dc.contributor.authorNavarro-Mateu, Fernando
dc.contributor.authorNishi, Daisuke
dc.contributor.authorPiazza, Marina
dc.contributor.authorPosada-Villa, José
dc.contributor.authorScott, Kate M.
dc.contributor.authorVladescu, Cristian
dc.contributor.authorWojtyniak, Bogdan
dc.contributor.authorZarkov, Zahari
dc.contributor.authorKessler, Ronald C.
dc.contributor.authorKessler, Ronald
dc.contributor.authorKessler, Timothy
dc.contributor.authorZaslavsky, Alan M.
dc.contributor.authorXavier, Miguel
dc.contributor.authorXavier, Miguel
dc.contributor.authorWoodruff, Peter
dc.contributor.authorWilliams, David R.
dc.contributor.authorTorres, Yolanda
dc.contributor.authorHave, Margreet ten
dc.contributor.authorStagnaro, Juan Carlos
dc.contributor.authorMedina-Mora, Maria Elena
dc.contributor.authorMcGrath, John J.
dc.contributor.authorKiejna, Andrzej
dc.contributor.authorKhaled, Salma
dc.contributor.authorKawakami, Norito
dc.contributor.authorKaram, Georges
dc.contributor.authorKaram, Aimee Nasser
dc.contributor.authorJonge, Peter de
dc.contributor.authorHu, Chi Yi
dc.contributor.authorHinkov, Hristo
dc.contributor.authorCaldas-de-Almeida, Jose Miguel
dc.contributor.authorJM, Caldas-de-Almeida
dc.contributor.authorCardoso, Graça
dc.contributor.authorCardoso, Graca
dc.contributor.authorGuzman, Ma Lourdes Rosanna E.de
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblBioMed Central (BMC)
dc.date.accessioned2025-03-24T21:15:47Z
dc.date.available2025-03-24T21:15:47Z
dc.date.issued2025-02
dc.descriptionFunding Information: The World Mental Health Survey collaborators are Sergio Aguilar-Gaxiola, MD, PhD; Ali Al-Hamzawi, MD; Jordi Alonso, MD, PhD; Yasmin A. Altwaijri, PhD; Laura Helena Andrade, MD, PhD; Lukoye Atwoli, MD, PhD; Corina Benjet, PhD; Guilherme Borges, ScD; Evelyn J. Bromet, PhD; Ronny Bruffaerts, PhD; Brendan Bunting, PhD; Jose Miguel Caldas-de-Almeida, MD, PhD; Gra\u00E7a Cardoso, MD, PhD; Stephanie Chardoul, BA; Alfredo H. C\u00EDa, MD; Louisa Degenhardt, PhD; Giovanni de Girolamo, MD; Ma. Lourdes Rosanna E. de Guzman, MD; Oye Gureje, MD, DSc, FRCPsych; Josep Maria Haro, MD, PhD; Meredith G. Harris, PhD; Hristo Hinkov, MD, PhD; Chi-yi Hu, MD, PhD; Peter de Jonge, PhD; Aimee Nasser Karam, PhD; Elie G. Karam, MD; Georges Karam, MD; Alan E. Kazdin, PhD; Norito Kawakami, MD, DMSc; Ronald C. Kessler, PhD; Salma Khaled, PhD; Andrzej Kiejna, MD, PhD; Viviane Kovess-Masfety, MD, PhD; John J. McGrath, MD, PhD; Maria Elena Medina-Mora, PhD; Jacek Moskalewicz, PhD; Fernando Navarro-Mateu, MD, PhD; Daisuke Nishi, MD, PhD; Marina Piazza, MPH, ScD; Jos\u00E9 Posada-Villa, MD; Kate M. Scott, PhD; Juan Carlos Stagnaro, MD, PhD; Dan J. Stein, FRCPC, PhD; Margreet ten Have, PhD; Yolanda Torres, MPH, Dra.HC; Maria Carmen Viana, MD, PhD; Daniel V. Vigo, MD, DrPH; Cristian Vladescu, MD, PhD; David R. Williams, MPH, PhD; Bogdan Wojtyniak, ScD; Peter Woodruff, MBBS, PhD, FRCPsych; Miguel Xavier, MD, PhD; Alan M. Zaslavsky, PhD. Publisher Copyright: © The Author(s) 2025.
dc.description.abstractBackground: High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. Methods: Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.7% female, median age [interquartile range]: 43 [31–57] years; 68.5% weighted average response rate) in the World Mental Health (WMH) surveys. We focus on the n = 5,136 respondents with 12-month DSM-IV anxiety, mood, or substance use disorders with perceived need for treatment. The n = 2,444 such respondents who did not receive treatment were asked about barriers to receiving treatment, whereas the n = 926 respondents who received treatment with a delay were asked about barriers leading to delays. Consistent with previous research, we distinguished five broad classes of barriers: low perceived disorder severity, two types of barriers in the domain of predisposing factors (beliefs/attitudes about treatment ineffectiveness and stigma) and two types in the domain of enabling factors (financial and nonfinancial). Baseline predictors of receiving treatment found in a prior report (i.e., comparing the n = 2,692 respondents who received treatment with the n = 2,444 who did not) were examined as predictors of barriers, while barriers were examined as mediators of associations between these predictors and treatment. Results: Most respondents reported multiple barriers. Barriers among respondents who did not receive treatment included low perceived severity (52.9%), perceived treatment ineffectiveness (44.8%), nonfinancial (40.2%) and financial (32.9%) barriers in the domain of enabling factors, and stigma (20.6%). Barriers causing delays in treatment had a similar rank-order but were reported by higher proportions of respondents (X21 = 3.8–199.8, p = 0.050− < 0.001). Barriers were predicted by low education, disorder type, age, employment status, and financial obstacles. Predictors varied as a function of barrier type. Conclusions: A wide range of barriers to treatment exist among people with mental disorders even after a need for treatment is acknowledged. Most such individuals have multiple barriers. These results have important implications for the design of programs to decrease unmet need for treatment of mental disorders.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent1065891
dc.identifier.doi10.1186/s13033-024-00658-2
dc.identifier.issn1752-4458
dc.identifier.otherPURE: 113624290
dc.identifier.otherPURE UUID: 937eaec0-0ef9-4dfe-8b0d-9693403e9bcd
dc.identifier.otherScopus: 85218274891
dc.identifier.urihttp://hdl.handle.net/10362/181237
dc.identifier.urlhttps://www.scopus.com/pages/publications/85218274891
dc.language.isoeng
dc.peerreviewedyes
dc.subjectBarriers to treatment
dc.subjectHealth services accessibility
dc.subjectMental disorder treatment
dc.subjectMental disorders
dc.subjectMental health services
dc.subjectTreatment delays
dc.subjectTreatment gap
dc.subjectUse of health services
dc.subjectPhychiatric Mental Health
dc.subjectHealth Policy
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectPsychiatry and Mental health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleBarriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveysen
dc.typejournal article
degois.publication.issue1
degois.publication.titleInternational Journal of Mental Health Systems
degois.publication.volume19
dspace.entity.typePublication
person.familyNameKessler
person.familyNameXavier
person.familyNamecaldas de almeida
person.familyNameCardoso
person.givenNameRonald
person.givenNameMiguel
person.givenNamejosé miguel
person.givenNameGraça
person.identifier.ciencia-idD71F-6F62-6CFA
person.identifier.ciencia-idA217-C270-9BA2
person.identifier.ciencia-id9F16-E03A-E150
person.identifier.orcid0000-0003-4831-2305
person.identifier.orcid0000-0003-2698-1284
person.identifier.orcid0000-0003-1902-6772
person.identifier.orcid0000-0003-1756-0197
person.identifier.scopus-author-id7006066808
person.identifier.scopus-author-id6506787166
person.identifier.scopus-author-id7005057979
rcaap.rightsopenAccess
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