Adequate Care Uncommon for Mentally Ill
May 16, 2000 -- Most people with common mental illnesses such as anxiety and depression are not receiving adequate care, according to a new study. Despite advances in treatment, primary care physicians -- and even psychiatrists -- are not treating patients aggressively enough.
The results of this study provide evidence of the continuing challenges faced by those with mental illness and by those who treat mental illness in the U.S., according to lead author Philip S. Wang, MD, DrPH. "Despite the availability of an increasing number of effective treatments, many of those with common mental disorders fail to receive at least some form of mental health care." Wang is with Harvard Medical School and Brigham and Women's Hospital in Boston.
While previous studies had found that only a small number of mentally ill patients are treated for their illnesses, the authors wanted to determine if dramatic changes in the 1990s such as more effective medications and managed care had led to significant improvements in mental health care for patients.
The researchers performed a phone and mail survey of more than 3,000 people diagnosed with one of three common mental illnesses: depression, panic disorder, and anxiety disorder.
Slightly more than 50% of people with any of these three disorders received any mental health treatment. Most of those patients received help from health care providers, although about 10% received self-help care, such as attending a group with other people with similar disorders, and another 10% received care from religious or spiritual advisors.
Only 13% of the patients found help from a psychiatrist, while 19% dealt with other mental health specialists such as psychologists, social workers, therapists or counselors. The largest group -- nearly 40% -- was treated by primary care physicians.
Wang and colleagues defined adequate treatment as either receiving a prescription medication for depression or anxiety from a general medical doctor or psychiatrist, plus at least four visits to the same type of provider. Adequate care without medication was defined as at least six visits to either a psychiatrist or mental health specialist, according to Wang. At least six visits are thought necessary for effective psychotherapy.