Most people in the world with mental illness get no treatment at all, and scarce mental health resources are not reaching the people who need them most, U.S. researchers said on Thursday.
“The treatment data we have are pretty troubling,” said Dr. Philip Wang of the U.S. National Institute of Mental Health, whose study appears in the Lancet medical journal.
Wang and colleagues studied mental health treatment data on 84,850 adults in 17 developed and developing countries taken from the World Health Organization’s mental health surveys.
The lack of mental health treatment was most severe in less-developed countries, where only a few people with serious disorders received any treatment in the past year.
But even in developed nations, roughly half of those with severe disorders got no care at all.
“Even in the United States, which is by far the most resourced country, it is by no means adequate. In our country, folks who meet the criteria for the most serious illness, only about half get anything,” Wang said in a telephone interview.
“Many aren’t receiving healthcare at all. The situation is concerning,” he said.
Patients who were male, married, less-educated and at the extremes of age or income got the least amount of care, the researchers found.
Not surprisingly, the number of people using any mental health services was generally lower in developing countries compared with developed countries.
The researchers also found a correlation between use of mental health services and the percentage of a nation’s gross domestic product spent on health services.
But Wang and colleagues also found that resources are poorly allocated when they are used.
And while efforts to control mental health spending, such as utilization review and prior authorization, might reduce use, they do little to direct care to the neediest patients.
“We’re good at reducing utilization. We’re not so good at channeling it among the people with the greatest need,” Wang said.