Survey finds broad need for better mental health care

Determining which mental disorders lead to long-term disability is seen as important to properly focus treatment resources.

By Susan J. Landers, AMNews staff. June 27, 2005.

Washington -- Most Americans will meet the diagnostic criteria for one or more mental health disorders at some time in their life but many never seek treatment, according to a large mental health tracking survey, the first conducted in a decade.

Of those who do seek help, twice as many are seen by primary care physicians or nurses as are seen by psychiatrists, said researchers who reported the results of the National Comorbidity Survey Replication, or NCS-R, in the June issue of the Archives of General Psychiatry.

A key finding of the household survey of more than 9,000 English-speaking adults is that mental disorders are highly prevalent and are chronic, said Thomas R. Insel, MD, director of the National Institute of Mental Health, which funded the survey along with support from foundations and pharmaceutical companies.

But the good news is that most cases are mild, said Ronald Kessler, PhD, professor of health care policy at Harvard Medical School and the study's lead investigator. Some resolve on their own and a lifestyle change may alter others, he added. "For example a snake phobia is a mental disorder, but if you live on the 35th floor of a Manhattan high-rise, it's not likely to get in the way of your life very much."

However, many of the disorders do get in the way, said the researchers, who used diagnostic criteria set out in the fourth edition of the American Psychiatric Assn.'s Diagnostic and Statistical Manual. "We need to do a better job at figuring out which mild or moderate disorders that exist today are likely to become seriously debilitating in the future," said Dr. Kessler. "We need to know which disorders to go after because clearly we can't treat one-quarter of the population."