Evidence map›Paper›PMID 39924481›Full record

ArticleInternational journal of mental health systems2025

Barriers to 12-month treatment of common anxiety, mood, and substance use disorders in the World Mental Health (WMH) surveys.

Maria Carmen Viana, Alan E Kazdin, Meredith G Harris, Dan J Stein, Daniel V Vigo, Irving Hwang, Sophie M Manoukian, Nancy A Sampson, Jordi Alonso, Laura Helena Andrade and 21 more

Abstract read
In one paragraph

Article in International journal of mental health systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

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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.

Maria Carmen VianaDepartment of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Vitória, ES, CEP 29.043-900, Brazil.
Alan E KazdinDepartment of Psychology, Yale University, 2 Hillhouse Avenue, 208205, New Haven, CT, 06520, USA.
Meredith G HarrisSchool of Public Health, The University of Queensland, C/O QCMHR, Locked Bag 500, Archerfield, QLD, 4108, Australia.
Dan J SteinDepartment of Psychiatry & Mental Health and South African Medical Council Research Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Rondebosch, Cape Town, 7925, ZA, South Africa.
Daniel V VigoDepartment of Psychiatry & School of Population and Public Health, Faculty of Medicine, University of British Columbia, UBC Hospital - Detwiller Pavilion, Room 2813, 2255 Wesbrook Mall, UBC Vancouver Campus, Vancouver, BC, V6T 2A1, Canada.
Irving HwangDepartment of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA.
Sophie M ManoukianDepartment of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA.
Nancy A SampsonDepartment of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA.
Jordi AlonsoIMIM-Hospital del Mar Medical Research Institute, PRBB Building, Doctor Aiguader, 88, 08003, Barcelona, Spain.
Laura Helena AndradeUniversity of São Paulo Medical School, Núcleo de Epidemiologia Psiquiátrica - LIM 23, Rua Dr. Ovidio Pires de Campos, 785, São Paulo, CEP 05403-010, Brazil.
Guilherme BorgesNational Institute of Psychiatry Ramón de La Fuente Muñiz, Calz. Mexico-Xochimilco 101, San Lorenzo Huipulco, 14370, Ciudad de Mexico, Mexico.
Brendan BuntingSchool of Psychology, Ulster University, Coleraine Campus, Coleraine, BT52 1SA, UK.
José Miguel Caldas-de-AlmeidaLisbon Institute for Global Mental Health, Comprehensive Health Research Centre Nova University of Lisbon, Rua Do Instituto Bacteriológico, 5, 1150-190, Lisbon, Portugal.
Giovanni de GirolamoIRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni 4, Brescia, Italy.
Peter de JongeDepartment of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
Oye GurejeDepartment of Psychiatry, University of Ibadan, University College Hospital, PMB 5116, Ibadan, Nigeria.
Josep Maria HaroParc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain.
Elie G KaramInstitute for Development, Research, Advocacy and Applied Care (IDRAAC), Achrafieh, St. George Hospital Street, Beirut, Lebanon.
Viviane Kovess-MasfetyInstitut de Psychologie, UR 4057, Université Paris Cité, 71 avenue Édouard Vaillant, Boulogne Billancourt, 92100, Paris, France.
Jacek MoskalewiczDepartment of Psychiatry, Institute of Psychiatry and Neurology, Jana III Sobieskiego 9, 02-957, Warsaw, Poland.
Fernando Navarro-MateuUnidad de Docencia, Investigacion y Formación en Salud Mental, Servicio Murciano de Salud, Murcia Health Service, C/Lorca, no 58. -El Palmar, 30120, Murcia, Spain.
Daisuke NishiDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
Marina PiazzaFacultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, San Martín de Porres, 15102, Lima, Peru.
José Posada-VillaColombian Institute of the Nervous System, Clinica Montserrat University Hospital, Calle 134 No. 17-71, Bogotá, Colombia.
Kate M ScottDepartment of Psychological Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Cristian VladescuNational Institute for Health Services Management, 31 Vaselor Str., 21253, Bucharest, Romania.
Bogdan WojtyniakNational Institute of Public Health, National Research Institute, 24 Chocimska St., 00-791, Warsaw, Poland.
Zahari ZarkovDepartment of Mental Health, National Center of Public Health and Analyses, 15, Acad. Ivan Geshov Blvd., 1431, Sofia, Bulgaria.
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA. kessler@hcp.med.harvard.edu.
Timothy KesslerThe Watson Institute for International and Public Affairs, Brown University, Providence, RI, United States.
World Mental Health Survey collaborators

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
CROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000R01DA016558 · NIDA · MICHIGAN STATE UNIVERSITY · PI ANTHONY, JAMES CHRISTOPHER · 2003 to 2008
$1.7M
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 FIRCA R03-TW006481FIC NIH HHS R03 TW006481John D. and Catherine T. MacArthur Foundation R13-MH066849NIDA NIH HHS R01 DA016558NIMH NIH HHS R01 MH069864NIMH NIH HHS R01 MH070884NIMH NIH HHS R13 MH066849NIMH NIH HHS U01 MH060220NIMH NIH HHS U01-MH60220Pfizer Foundation R01-MH069864Robert Wood Johnson Foundation 044708
6 · The paper itself

Abstract

backgroundHigh unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem.

methodsData on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.7% female, median age [interquartile range]: 43 [31-57] years; 68.5% weighted average response rate) in the World Mental Health (WMH) surveys. We focus on the n = 5,136 respondents with 12-month DSM-IV anxiety, mood, or substance use disorders with perceived need for treatment. The n = 2,444 such respondents who did not receive treatment were asked about barriers to receiving treatment, whereas the n = 926 respondents who received treatment with a delay were asked about barriers leading to delays. Consistent with previous research, we distinguished five broad classes of barriers: low perceived disorder severity, two types of barriers in the domain of predisposing factors (beliefs/attitudes about treatment ineffectiveness and stigma) and two types in the domain of enabling factors (financial and nonfinancial). Baseline predictors of receiving treatment found in a prior report (i.e., comparing the n = 2,692 respondents who received treatment with the n = 2,444 who did not) were examined as predictors of barriers, while barriers were examined as mediators of associations between these predictors and treatment.

resultsMost respondents reported multiple barriers. Barriers among respondents who did not receive treatment included low perceived severity (52.9%), perceived treatment ineffectiveness (44.8%), nonfinancial (40.2%) and financial (32.9%) barriers in the domain of enabling factors, and stigma (20.6%). Barriers causing delays in treatment had a similar rank-order but were reported by higher proportions of respondents (X

conclusionsA wide range of barriers to treatment exist among people with mental disorders even after a need for treatment is acknowledged. Most such individuals have multiple barriers. These results have important implications for the design of programs to decrease unmet need for treatment of mental disorders.

Indexed as

Barriers to treatmentHealth services accessibilityMental disordersMental disorder treatmentMental health servicesTreatment delaysTreatment gapUse of health services

Identifiers

PMID39924481
PMCPMC11807321

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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.