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

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  • dc.contributor.author Viana, Maria Carmen
  • dc.contributor.author Alonso Caballero, Jordi
  • dc.contributor.author World Mental Health Survey collaborators
  • dc.date.accessioned 2025-03-21T08:33:32Z
  • dc.date.available 2025-03-21T08:33:32Z
  • dc.date.issued 2025
  • dc.description.abstract Background: 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.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Viana MC, Kazdin AE, Harris MG, Stein DJ, Vigo DV, Hwang I, et al. Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys. Int J Ment Health Syst. 2025 Feb 9;19(1):6. DOI: 10.1186/s13033-024-00658-2
  • dc.identifier.doi http://dx.doi.org/10.1186/s13033-024-00658-2
  • dc.identifier.issn 1752-4458
  • dc.identifier.uri http://hdl.handle.net/10230/69987
  • dc.language.iso eng
  • dc.publisher BioMed Central
  • dc.relation.ispartof Int J Ment Health Syst. 2025 Feb 9;19(1):6
  • dc.rights © [Author(s)]. Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0/
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
  • dc.subject.keyword Barriers to treatment
  • dc.subject.keyword Health services accessibility
  • dc.subject.keyword Mental disorder treatment
  • dc.subject.keyword Mental disorders
  • dc.subject.keyword Mental health services
  • dc.subject.keyword Treatment delays
  • dc.subject.keyword Treatment gap
  • dc.subject.keyword Use of health services
  • dc.title Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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