Study Shows Many Mental Health Needs Go Unmet

The study focused on Baltimore, where a team  of psychiatrists interviewed 816 people between 1993 and 1999.

They found the greatest need was  treatment of alcohol dependence, nearly 14 percent, and major depression, nearly  11 percent.

“There are a lot of people who need  psychiatric care who aren’t getting any,” says Dr. Erick Messias, psychiatrist  at the Medical College of Georgia and lead author on the study in the March  issue of Psychiatric Services. “There  is a constellation of factors keeping people away from that care. This  translates into people suffering for years, when there is a solution.”

He notes that many people don’t even  seek help, some because they believe they’ll get better on their own. A  perceived lack of efficacy of treatment, societal pressures, stigma and a lack  of comprehensive insurance coverage for mental health also are factors. Insufficient  numbers of mental health professionals also impede access.

In his own practice, Dr. Messias sees  people who have struggled for years before they finally seek help. While he  acknowledges that seeking help won’t always cure the problem, he believes it  can decrease most people’s pain.

The study looked at the most common  mental health problems, social phobia, panic disorder and agoraphobia – in  addition to depression and alcohol dependence. These problems may not require  medication but could benefit from treatment, from psychotherapy to programs  such as Alcoholics Anonymous, he says.

Interestingly those with severe  mental illness, such as schizophrenia, are more likely to get help. “However,  from a public health perspective these conditions, albeit causing great pain  and suffering, compared to prevalent mental disorders, affect a smaller  proportion of the population" Dr. Messias says.

“Prevalence of mental  disorders is only an approximation of the need for treatment,” he and  co-authors write. “There is a substantial need for mental health  services in the general population.”

Dr. Messias suggests that Baltimore’s population reflects the prevalence and unmet  needs of most larger cities, such as New York,  Chicago and Atlanta. Studies are needed to see how midsize  and small cities fare, he says.

What is clear is more mental health  professionals are needed across the spectrum, including psychiatrists,  psychologists, social workers and occupational therapists, and those  professionals need to work as teams to maximize impact, he says.

He estimates that within his own  practice, a psychologist working with him would enable him to double his  patient load.

Acknowledging that it can be  difficult for individuals to decide they need any level of mental health care,  Dr. Messias says there are some key indicators. “I always ask patients how they  sleep, because the way you sleep tells me a lot about how well you are,” he  says. “If you are so tired you are sleeping all the time or you can’t sleep,  that’s a sign that something on your mind is not letting you relax.” Work and  personal relationships are two other good indicators. “If you can love and  work, you probably will do fine.”

Researchers at Johns Hopkins   University are co-authors  on the study which was funded by the National Institute of Mental Health.