In the Journals

Many people with mental health disorders do not receive treatment

Mark Olfson, MD, MPH
Mark Olfson

Most U.S. adults with mental health disorders have not received treatment for their conditions in the last year, and treatment rates were especially low for substance use disorders, according to 2012 to 2013 data from the National Epidemiologic Survey on Alcohol and Related Conditions-III.

“Because of changes in public and personal attitudes toward mental health treatment, shifts in the health care policy landscape and alterations in the clinical context within which mental health services are provided, it is important to have timely information on national patterns of mental health treatment,” Mark Olfson, MD, MPH, of the New York State Psychiatric Institute, Columbia University, and colleagues wrote in Journal of Clinical Psychiatry.

Using nationally representative survey data from structured diagnostic interviews, researchers analyzed past 12-month disorder-specific mental health treatment patterns of common DSM-5 disorders in 36,309 U.S. adults. They estimated percentages of respondents with mood, anxiety and substance use disorders who received disorder-specific treatment in year prior to the interview.

Analysis showed that people with mood disorders received treatment most often (37.8%; 95% CI, 36.1-39.6) followed by anxiety disorders (24.1%; 95% CI, 22.6-25.6), but less than one in five of people received treatment for substance use disorders (18.8%; 95% CI, 17.8-19.8).

The results showed that people with panic disorder had the highest treatment rate among those with an anxiety disorder (47.9%; 95% CI, 43.9-52) and people with tobacco use disorder had the highest treatment rate among those with a substance use disorder (20.3%; 95% CI, 19-21.7).

Olfson and colleagues also found that U.S. adults with mood and anxiety disorders (53.1%; 95% CI, 49.7-56.4) were more likely than adults with only mood (32%; 95% CI, 29.5-34.6) or only anxiety (13.2%; 95% CI, 11.6-15) disorders to receive mental health treatment.

Lack of insurance coverage increased the odds of not receiving treatment for almost all mental disorders, excluding specific phobia (OR = 0.55; 95% CI, 0.3-1.03), non-tobacco drug use disorders (OR = 0.8; 95% CI, 0.47-1.36) and alcohol use disorder (OR = 1.52; 95% CI, 1.12-2.07).

“Over the last several years, progress has been made in increasing treatment of adults with depression. These gains reflect the combined efforts of policymakers, advocates, patients and clinicians,” the investigators concluded. “As the opioid crisis continues, such programs should inspire broader initiatives to promote public acceptance of mental health and substance use treatment, reform payment approaches to reimburse costs of providing adequate care and develop a behavioral health care workforce capable of narrowing gaps in unmet need for treatment." – by Savannah Demko

Disclosure: Olfson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Mark Olfson, MD, MPH
Mark Olfson

Most U.S. adults with mental health disorders have not received treatment for their conditions in the last year, and treatment rates were especially low for substance use disorders, according to 2012 to 2013 data from the National Epidemiologic Survey on Alcohol and Related Conditions-III.

“Because of changes in public and personal attitudes toward mental health treatment, shifts in the health care policy landscape and alterations in the clinical context within which mental health services are provided, it is important to have timely information on national patterns of mental health treatment,” Mark Olfson, MD, MPH, of the New York State Psychiatric Institute, Columbia University, and colleagues wrote in Journal of Clinical Psychiatry.

Using nationally representative survey data from structured diagnostic interviews, researchers analyzed past 12-month disorder-specific mental health treatment patterns of common DSM-5 disorders in 36,309 U.S. adults. They estimated percentages of respondents with mood, anxiety and substance use disorders who received disorder-specific treatment in year prior to the interview.

Analysis showed that people with mood disorders received treatment most often (37.8%; 95% CI, 36.1-39.6) followed by anxiety disorders (24.1%; 95% CI, 22.6-25.6), but less than one in five of people received treatment for substance use disorders (18.8%; 95% CI, 17.8-19.8).

The results showed that people with panic disorder had the highest treatment rate among those with an anxiety disorder (47.9%; 95% CI, 43.9-52) and people with tobacco use disorder had the highest treatment rate among those with a substance use disorder (20.3%; 95% CI, 19-21.7).

Olfson and colleagues also found that U.S. adults with mood and anxiety disorders (53.1%; 95% CI, 49.7-56.4) were more likely than adults with only mood (32%; 95% CI, 29.5-34.6) or only anxiety (13.2%; 95% CI, 11.6-15) disorders to receive mental health treatment.

Lack of insurance coverage increased the odds of not receiving treatment for almost all mental disorders, excluding specific phobia (OR = 0.55; 95% CI, 0.3-1.03), non-tobacco drug use disorders (OR = 0.8; 95% CI, 0.47-1.36) and alcohol use disorder (OR = 1.52; 95% CI, 1.12-2.07).

“Over the last several years, progress has been made in increasing treatment of adults with depression. These gains reflect the combined efforts of policymakers, advocates, patients and clinicians,” the investigators concluded. “As the opioid crisis continues, such programs should inspire broader initiatives to promote public acceptance of mental health and substance use treatment, reform payment approaches to reimburse costs of providing adequate care and develop a behavioral health care workforce capable of narrowing gaps in unmet need for treatment." – by Savannah Demko

Disclosure: Olfson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.