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Comparative Study
. 2004 Apr;39(2):393-415.
doi: 10.1111/j.1475-6773.2004.00234.x.

Delays in initial treatment contact after first onset of a mental disorder

Philip S Wang  1 , Patricia A Berglund, Mark Olfson, Ronald C Kessler
Affiliations
Comparative Study

Delays in initial treatment contact after first onset of a mental disorder

Philip S Wang et al. Health Serv Res. 2004 Apr.

Abstract

Objective: To examine nationally representative patterns and predictors of delays in contacting a professional after first onset of a mental disorder.

Data sources: The National Comorbidity Survey, a nationally representative survey of 8,098 respondents aged 15-54.

Study design: Cross-sectional survey.

Data collection: Assessed lifetime DSM-III-R mental disorders using a modified version of the Composite International Diagnostic Interview (CIDI). Obtained reports on age at onset of disorders and age of first treatment contact with each of six types of professionals (general medical doctors, psychiatrists, other mental health specialists, religious professionals, human services professionals, and alternative treatment professionals). Used Kaplan-Meier (KM) curves to estimate cumulative lifetime probabilities of treatment contact after first onset of a mental disorder. Used survival analysis to study the predictors of delays in making treatment contact.

Principal findings: The vast majority (80.1 percent) of people with a lifetime DSM-III-R disorder eventually make treatment contact, although delays average more than a decade. The duration of delay is related to less serious disorders, younger age at onset, and older age at interview. There is no evidence that delay in initial contact with a health care professional is increased by earlier contact with other non-health-care professionals.

Conclusions: Within the limits of recalling lifetime events, it appears that delays in initial treatment contact are an important component of the larger problem of unmet need for mental health care. Interventions are needed to decrease these delays.

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Figures

Figure 1
Figure 1
Cumulative Probabilities of Contacting Specific Professionals after First Onset of Mental Disorders among Respondents with a Lifetime History of Mental Disorders Note: For more detailed description of each specific type of professional, see the footnotes included on Tables 1 and 3.
Figure 2
Figure 2
Cumulative Probabilities of Contacting Any Professional after First Onset of Mental Disorders, Shown for Specific Age Cohorts
Figure 3
Figure 3
Cumulative Probabilities of Contacting Any Professional for Mental Disorder among Those Making Any Treatment Contact, Shown Separately for Groups Defined by the Age of Disorder Onset
Figure 4
Figure 4
Cumulative Probabilities of Contacting Any Professional for Mental Disorder among Those Making Any Treatment Contact, Shown Separately for Groups Defined by the Number of Markers of Disorder
See this image and copyright information in PMC

Comment in

References

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