Few receive effective treatment for mental health, substance use
Key takeaways:
- Under half of people with a disorder recognized a need for treatment, while even fewer ended up seeking treatment.
- Most who sought treatment for their disorder received a minimum level of adequate treatment.
Less than 7% of individuals with mental health or substance use disorders receive effective treatment worldwide, according to a cross-sectional analysis published in JAMA Psychiatry.
The findings indicated that a person’s inability to recognize the need for intervention served as the greatest barrier to accessing effective treatment.
“This survey data has allowed us to create the only effective treatment indicator that exists for mental health and substance use,” Daniel Vigo, MD, DrPH, an associate professor at the University of British Columbia in Canada, said in a press release. “Policy decisions and allocative decisions for funding should be guided by data, and this hasn’t always been the case in the realm of mental health and substance use.”
In the study, Vigo and colleagues determined the proportion of those receiving effective treatment meeting evidence-based guidelines. The study group comprised 56,927 World Mental Health survey respondents across 21 countries.
The researchers included adult respondents who met the criteria for a disorder under the Diagnostic and Statistical Manual of Mental Disorders-IV.
They evaluated the proportion of individuals who moved from one step to the next during a four-step treatment process. These steps included:
- recognition of a need for treatment;
- contact with the health care system to receive treatment;
- receiving a minimum level of adequate treatment; and
- receiving effective treatment.
Vigo and colleagues reported that 46.5% of people who met the criteria for a diagnosis recognized their need for treatment, and of those, 34.1% looked to receive treatment.
Almost all people who sought help received a minimum level of adequate treatment (82.9%), whereas just 47% of those who received such a level of treatment eventually received effective treatment.
Effective treatment occurred more frequently among several subgroups, like women (RR = 1.5; 95% CI, 1.2-1.8), those aged 30 to 59 years (RR = 1.4; 95% CI, 1.1-1.9) and those with higher education (RR = 1.6; 95% CI, 1.1-2.2).
According to the release, attrition at various points throughout the process meant that only 6.9% of people ended up receiving effective treatment. This percentage significantly varied among disorders, ranging from 1.4% for alcohol use disorder to 12% for generalized anxiety disorder.
The researchers identified some study limitations. For example, treatment data was self-reported, while the data was pooled and not country specific.
“Understanding where the bottlenecks are for each of these disorders provides a unique and previously unavailable blueprint for decision makers to understand problems objectively and try to adjust the system,” Vigo said in the release.
He explained it is critical that clinicians have appropriate training, considering that they are usually peoples’ first point of contact in the health care system.
“Improving the ability of these general practitioners and family doctors to diagnose and treat the mild to moderate forms, and to know when to refer more severely affected folks to specialists, becomes the cornerstone of the system,” Vigo said.
References:
- Only seven out of 100 people worldwide receive effective treatment for their mental health or substance-use disorders. Available at: https://news.ubc.ca/2025/02/global-study-of-mental-health-treatment/. Published Feb. 5, 2025. Accessed Feb. 18, 2025.
- Vigo D, et al. JAMA Psychiatry. 2025;doi:10.1001/jamapsychiatry.2024.4378.