The prevalence and correlates of untreated serious mental illness.

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Health Services Research (Impact Factor: 2.49). 01/2002; 36(6 Pt 1):987-1007.
Source: PubMed

ABSTRACT To identify the number of people in the United States with untreated serious mental illness (SMI) and the reasons for their lack of treatment. DATA SOURCE/STUDY DESIGN: The National Comorbidity Survey; cross-sectional, nationally representative household survey.
An operationalization of the SMI definition set forth in the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act identified individuals with SMI in the 12 months prior to the interview. The presence of SMI then was related to the use of mental health services in the past 12 months.
Of the 6.2 percent of respondents who had SMI in the year prior to interview, fewer than 40 percent received stable treatment. Young adults and those living in nonrural areas were more likely to have unmet needs for treatment. The majority of those who received no treatment felt that they did not have an emotional problem requiring treatment. Among those who did recognize this need, 52 percent reported situational barriers, 46 percent reported financial barriers, and 45 percent reported perceived lack of effectiveness as reasons for not seeking treatment. The most commonly reported reason both for failing to seek treatment (72 percent) and for treatment dropout (58 percent) was wanting to solve the problem on their own.
Although changes in the financing of services are important, they are unlikely by themselves to eradicate unmet need for treatment of SMI. Efforts to increase both self-recognition of need for treatment and the patient centeredness of care also are needed.

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    Advances in Mental Health. 12/2014; 12(3):202-215.
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    ABSTRACT: Increasing the acceptance of Internet-based mental health interventions in primary care patients with depressive symptoms. A randomized controlled trial. Ebert, D.D. 123, Berking, M. 2134, Cuijpers, P. 14, Lehr, D.1, Pörtner, M. 2, Baumeister, H.56 1 Leuphana University, Innovation Incubator, Division Health Trainings online, Lueneburg, Germany 2 Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Erlangen, Germany 3 Department for Health Care Policy, Harvard Medical School, Harvard University, Boston, USA 3 GGZ in Geest, Regional Mental Health Service Centre, VU University Medical Centre, Amsterdam, the Netherlands 4 Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, the Netherlands 5 Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany 6 Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany For Publication in: Journal of Affective Disorders *Corresponding author: David Daniel Ebert Friedrich-Alexander-University Erlangen-Nürnberg Clinical Psychology and Psychotherapy Bismarckstr. 1, 91054 Erlangen, Germany Background: Internet-based interventions (IBI) are effective in treating depression. However, uptake rates in routine care are still limited. Hence, this study aimed to (1) assess the acceptance of IBIs in primary care patients with depressive symptoms and to (2) examine the effects of a brief acceptance facilitating intervention in the form of an informational video on patients’ acceptance of IBIs. Methods: Primary care patients (N=128) with Minor or Major Depression were randomly assigned to an intervention (IG) or control group (CG). Patients in the IG were shown a brief informational video about IBIs before receiving a questionnaire that assessed their acceptance of IBIs and other secondary outcomes. Patients of the CG filled out the questionnaire immediately. Results: Baseline acceptance of IBIs in the CG was high for 6.3%, moderate for 53.1% and low for 40.6% of patients. Acceptance of IBIs was significantly higher in the IG when compared to the CG (d=0.71, 95%-CI:0.09-2.91). Except for social influence and the general attitude towards psychological treatment, all secondary outcomes were also significantly improved (e.g. effort- (d=0.40) and performance-expectancy: d=0.65; knowledge about Internet interventions d=0.35). Limitations: Depression of the participants was only assessed using a self-report measure (PHQ-9). Conclusion: Primary care patients’ acceptance of IBIs for depressive symptoms was low but could be increased significantly using a brief acceptance facilitating intervention on the basis of an informational video. Future studies should further examine the potential of acceptance facilitating interventions for patients and health care providers to exploit the public health impact of IBIs.
    Journal of Affective Disorders 02/2015; 176C. · 3.76 Impact Factor
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    Advances in Mental Health 01/2014; 12(3):202-215.

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