Adequate Care for Mental Disorders Is Still the Exception

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Adequate Care for Mental Disorders Is Still the Exception

Rates of recognition of mental disorders have remained low over the years. Using data from a telephone household survey originally involving 9585 individuals interviewed twice, these researchers analyzed the care received by 1636 respondents with 1 or more probable DSM-IIIR depressive disorders, anxiety disorders, or both.

Over 1 year, 81 percent of the respondents saw a primary care practitioner (PCP); 21 percent received the correct dosage of an appropriate medication, and 18 percent received at least 4 psychotherapy or counseling sessions. Adequate pharmacotherapy or psychotherapy was more common for respondents receiving care from a mental health professional than from a PCP (89 percent to 90 percent vs. 20 percent of patients treated by each provider type, respectively), but only 19 percent of respondents with a mental disorder actually saw a mental health professional, most after referral by a PCP. Having insurance coverage increased the likelihood of contact with a health care provider but did not ensure an effective level of mental health care. Respondents who received inadequate care were less likely to report evaluation of a mental health problem.

Comment: These findings suggest that the vigorous efforts to educate primary care practitioners to recognize and treat common psychiatric disorders have not yet fully succeeded. Perhaps, respondents who were aware of having psychiatric symptoms were more likely to accept referral to mental health specialists. Adequate treatment of those less willing to acknowledge their symptoms may have been limited by patient compliance as much as by the skill of the PCP.

— S Dubovsky

Published in Journal Watch Psychiatry February 6, 2001

Citation(s):

Young AS et al. The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry 2001 Jan 58 55-61.

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