Evidence map›Paper›PMID 23931656›Full record

ArticlePsychological medicine2014

Barriers to mental health treatment: results from the WHO World Mental Health surveys.

L H Andrade, J Alonso, Z Mneimneh, J E Wells, A Al-Hamzawi, G Borges, E Bromet, R Bruffaerts, G de Girolamo, R de Graaf and 21 more

6 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychological medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 547 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
547citing papers in PubMed, 6 pooled it
29.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04026152 nacompletednot on this mapstarted 2019, after this paper: background citation

Using the Unified Protocol to Reduce Exercise Anxiety and Improve Adherence to a Resistance Training Program for People With Anxiety-Related Disorders: A Randomized Controlled Trial

TypeinterventionalSponsorUniversity of ReginaRan2019 to 2020Enrolled59ConditionsAnxiety Disorders, Posttraumatic Stress Disorder, Obsessive-Compulsive DisorderArmsResistance training, Unified Protocol
NCT04640090 nacompletednot on this mapstarted 2020, after this paper: background citation

Effectiveness of a Smartphone Wellness App to Improve Mental Well-being: A Pilot Study

TypeinterventionalSponsorWashington University School of MedicineRan2020 to 2021Enrolled60ConditionsMusculoskeletal Diseases, Chronic Pain, Anxiety Disorders, DepressionArmsSmartphone app (Wysa)
NCT05194722 nacompletednot on this mapstarted 2022, after this paper: background citation

Optimizing Implementation of Mental Health Intervention Within Orthopedic Care

TypeinterventionalSponsorWashington University School of MedicineRan2022 to 2022Enrolled30ConditionsAnxiety, Depression, Back Pain, Neck PainArmsWysa mobile app
NCT05449561 completednot on this mapstarted 2022, after this paper: background citation

Beyond Efficacy- Eliciting Preference for Face-to-face and Internet-based Psychotherapy Among People with Depression: Using Discrete Choice Experiment to Advance Future Service Implementation

TypeobservationalSponsorChinese University of Hong KongRan2022 to 2023Enrolled20ConditionsDepression
NCT05477420 nacompletednot on this mapstarted 2022, after this paper: background citation

A Survey Study and Effect of Web-based Decision Aids on Preferences Shift

TypeinterventionalSponsorChinese University of Hong KongRan2022 to 2024Enrolled148ConditionsDepression, PsychotherapiesArmsDecision Aid
NCT06434883 nacompletednot on this mapstarted 2024, after this paper: background citation

Assessment of an App-based Anxiety/Depression Program in a Population With Elevated Anxiety/Depression A Clinical Randomized Controlled Trial

TypeinterventionalSponsorUniversity of Southern DenmarkRan2024 to 2025Enrolled168ConditionsDepression Anxiety DisorderArmsAnxiety/Depression Program, Waitlist
3 · Its place in the literature

Who cites it

547 citing papers in PubMed, 6 syntheses or guidelines pooled it, 1,301 citations in OpenAlex.

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487 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 20 institutions in 23 countries.

L H AndradeSection of Psychiatric Epidemiology-LIM 23, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
J AlonsoHealth Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Z MneimnehInstitute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon.
J E WellsDepartment of Public Health and General Practice, University of Otago, Christchurch, New Zealand.
A Al-HamzawiAl-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq.
G BorgesInstituto Nacional de Psiquatria Ramon de la Fuente and Universidad Autonoma Metropolitana, Mexico DF, Mexico.
E BrometDepartment of Psychiatry, State University of New York at Stony Brook, Stony Brook, NY, USA.
R BruffaertsUniversitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium.
G de GirolamoIRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
R de GraafTrimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
S FlorescuNational School of Public Health Management and Professional Development, Bucharest, Romania.
O GurejeDepartment of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria.
H R HinkovNational Center for Public Health and Analyses, Sofia, Bulgaria.
C HuShenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, P. R. China.
Y HuangInstitute of Mental Health, Peking University, Beijing, P. R. China.
I HwangDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
R JinHarvard Pilgrim Health Care, Boston, MA, USA.
E G KaramInstitute for Development, Research, Advocacy and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon.
V Kovess-MasfetyEA 4069 Université Paris Descartes and Department of Epidemiology, EHESP School for Public Health, Paris, France.
D LevinsonResearch and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel.
H MatschingerInstitute of Social Medicine, Occupational Health and Public Health, Public Health Research Unit, University of Leipzig, Germany.
S O'NeillPsychology Research Institute, University of Ulster, Londonderry, UK.
J Posada-VillaPontificia Universidad Javeriana, Instituto Colombiano del Sistema Nervioso, Bogota, Colombia.
R SagarDepartment of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
N A SampsonDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
C SasuScoala Nationala de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar (SNSPMPDSB), Bucharest, Romania.
D J SteinDepartment of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Cape Town, South Africa.
T TakeshimaNational Institute of Mental Health, National Center of Neurology and Psychiatry, Japan.
M C VianaDepartment of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil.
M XavierMental Health Department, Faculdade Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
R C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Harvard University · USNational School of Public Health, Management and Professional Development · ROAll India Institute of Medical Sciences · INCentro San Giovanni di Dio Fatebenefratelli · ITÉcole des Hautes Études en Santé Publique · FRHarvard Pilgrim Health Care · USHospital Del Mar · ESInstitute for Development, Research, Advocacy and Applied Care · LBIsrael Ministry of Health · ILKU Leuven · BELeipzig University · DENational Center of Neurology and Psychiatry · JPNational Center of Public Health and Analyses · BGPeking University · CNPontificia Universidad Javeriana · COShenzhen KangNing Hospital · CNState University of New York · USTrimbos Institute · NLUniversidad Autónoma Metropolitana · MXUniversidade de São Paulo · BR

Funding

EPIDEMIOLOGY-- NATIONAL COMORBIDITY SURVEY REPLICATIONU01MH060220 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 1999 to 2010
$18.7M
Risk Factors for Psychopathology in the WHO WMH SurveysR01MH070884 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 2005 to 2009
$6.0M
Social Role Disability and Mental-Physical Co-MorbidityR01MH069864 · NIMH · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · PI VON KORFF, MICHAEL R · 2004 to 2007
$2.2M
COMORBID MENTAL DISORDERS IN PERIODS OF SOCIAL DISRUPTIOR01MH061905 · NIMH · STATE UNIVERSITY NEW YORK STONY BROOK · PI BROMET, EVELYN J · 2000 to 2004
$1.7M
CROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000R01DA016558 · NIDA · MICHIGAN STATE UNIVERSITY · PI ANTHONY, JAMES CHRISTOPHER · 2003 to 2008
$1.7M
Drug Dependence Epidemiology and EnviromicsK05DA015799 · NIDA · MICHIGAN STATE UNIVERSITY · PI ANTHONY, JAMES CHRISTOPHER · 2003 to 2015
$1.4M
World Mental Health Consortium Annual Meeting 2003-07R13MH066849 · NIMH · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HEERINGA, STEVEN G · 2003 to 2007
$735k
Lebanon-Epidemiology: The NCS Replication StudyR03TW006481 · FIC · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KESSLER, RONALD C · 2004 to 2006
$142k
FIC NIH HHS R03 TW006481FIC NIH HHS R03-TW006481FIC NIH HHS R03 TW006481-01NIDA NIH HHS K05 DA015799NIDA NIH HHS R01 DA016558NIMH NIH HHS R01 MH061905NIMH NIH HHS R01 MH069864NIMH NIH HHS R01-MH069864NIMH NIH HHS R01 MH070884NIMH NIH HHS R01MH070884NIMH NIH HHS R01-MH61905NIMH NIH HHS R13 MH066849NIMH NIH HHS R13-MH066849NIMH NIH HHS U01 MH060220NIMH NIH HHS U01-MH60220
6 · The paper itself

Abstract

backgroundTo examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.

methodData were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity.

resultsAmong those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).

conclusionsLow perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.

Indexed as

Attitude to HealthWorld Health OrganizationAdolescentAdultAgedAged, 80 and overFemaleGlobal HealthHealth Services AccessibilityHumansMaleMental Health ServicesMiddle AgedYoung Adult

Identifiers

PMID23931656
PMCPMC4100460
OpenAlexW2100695323

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.