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National Mental Health Survey Shows Mixed Results on Progress
Early Intervention Recommended for Children
 Photo by Steve Gilbert Although more Americans than ever are seeking mental health treatment, Ron Kessler found, the quality of care remains low. |
In a set of four papers published in the June Archives of General Psychiatry, the survey authors report that while the percentage of people getting mental health treatment has doubled in the last decade, a majority of Americans will have a mental health disorder at some time in their life, though most are mild; that these disorders often go untreated; and that even when treatment does occur, the care provided likely will not meet recommended guidelines for the disease. The study also found that mental disorders gain the strongest foothold among young people.
“It’s been a decade since the first National Comorbidity Survey was taken, and many important advances have been made in mental health care in terms of new medications, public attitudes, and financing of treatment,” said Ron Kessler, HMS professor of health care policy, who directed both the NCS-R and NCS. “Because of these factors, treatment has increased dramatically. We were hoping to see a decrease in disorder prevalence because of this, but we did not. Quality of treatment was found to be low in many cases. The good news, though, is that many cases were found to be mild.”
The study revealed that disorders that began in childhood, although often more serious than those starting in adulthood, were associated with the longest delays in seeking treatment. The researchers speculated that the reasons for this are that minors need the help of parents or other adults, and recognition of symptoms is often low among these adults unless symptoms are extreme.
Image by Rachel (Meyer) Eastwood
Who cares? Researchers found that over one year, 41 percent of people suffering a mental health disorder received some form of treatment. The graph shows who provided the care and (in parentheses) what percentage of patients received at least the minimal standard of care in each provider category.
“Given the enormous personal and societal burdens of mental disorders, these observations should lead us to direct a greater part of our thinking about mental health interventions to children,” Kessler said. “We should focus on early interventions aimed at preventing progression of primary disorders and the onset of multiple disorders.”
| “Given the enormous personal and societal burdens of mental disorders, these observations should lead us to direct a greater part of our thinking about mental health interventions to children.” |
“This new report demonstrates again that mental disorders are the chronic diseases of the young with high rates in the population,” said Thomas Insel, director of the National Institute of Mental Health. “While some of these disorders are mild, this survey also finds that 45 percent of those with mood disorders and over 20 percent of those with anxiety disorders are severely affected. Identifying the milder cases that will progress to severe will be an important goal for preventing disabling mental illness.”
The survey also found that mental health service use remains low, with the majority of cases not receiving any care in the prior year. Those who successfully accessed health care often did not receive treatment consistent with even minimally accepted standards in published treatment guidelines (see graph above).
Philip Wang, HMS assistant professor of health care policy, who was the lead investigator in the treatment study, said, “Interventions are needed to improve the quality of care delivered to patients with mental disorders. Several disease management programs that enhance treatment adequacy and adherence have already been proven successful and cost-effective. Performance standards could further optimize quality and help to monitor the impact of future interventions.”