Perceived need for alcohol, drug, and mental health treatment
To investigate determinants of perceived need for alcohol, drug, and mental (ADM) health treatment and differences in ADM treatment patterns between individuals with perceived need and those without.
We used data from a nationally representative telephone survey of 9585 adults conducted in 1997–1998. Logistic regression was used to study the determinants of perceived need and the correlation between perceived need and any ADM treatment, specialty ADM treatment, appropriate care, and medication adherence.
Just fewer than 37% of individuals with an ADM disorder perceived a need for treatment, while 4.6% of those without an ADM disorder perceived a need for treatment. Women, the young and middle aged, the better educated, those with greater emotional support, and those with greater psychiatric morbidity were more likely to perceive need for ADM services. Perceived need was strongly correlated with receiving ADM treatment, although almost 44% of individuals in ADM treatment did not perceive a need for treatment. Among individuals in ADM treatment, those with perceived need were significantly more likely to receive specialty ADM treatment, but not more likely to be treatment adherent, or to receive appropriate care.
Substantial levels of unmet need are likely to persist as long as perceived levels of need remain low. Interventions targeting perceived need may hold promise for decreasing unmet need.
Keywordsperceived need treatment seeking unmet need mental health substance abuse
- 2.Murray CJ, Lopez AD (eds) (1996) The global burden of disease. A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard School of Public Health, Cambridge, MAGoogle Scholar
- 4.Regier DA, Narrow WE, Rae DS, et al. (1992) The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry 50(2):85–94Google Scholar
- 7.Surgeon General (1999) Mental Health: A Report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Center for Mental Health Services, National Institutes of Health, National Institute of Mental HealthGoogle Scholar
- 25.Sturm R, Gresenz C, Sherbourne C, et al. (1999) The design of Healthcare for Communities: a study of health care delivery for alcohol, drug abuse, and mental health conditions. Inquiry 36:195–206Google Scholar
- 26.Kemper P, Blumenthal D, Corrigan JM, et al. (1996) The design of the community tracking study: a longitudinal study of health system change and its effects on people. Inquiry 36:221–233Google Scholar
- 30.World Health Organization (1995) Composite International Diagnostic Interview (CIDI) (version 2.1). Geneva, Switzerland: WHOGoogle Scholar
- 31.Bergner M (1984) The sickness impact profile (SIP). In: Wenger NK, Mattson ME, Furberg CD, Elinson J (eds) Assessment of quality of life in clinical trials of cardiovascular therapies, Le Jacq Publishing, New YorkGoogle Scholar
- 32.World Health Organization (1992) The alcohol use disorders identification test (AUDIT). Guidelines for use in primary health care. WHO, Geneva, SwitzerlandGoogle Scholar
- 36.Bell R (1999) Depression PORT Methods Workshop (I), RAND, Santa Monica, CAGoogle Scholar
- 37.Rubin DB (1987) Multiple imputation for non-response in surveys. J Wiley & Sons, New YorkGoogle Scholar
- 38.Regier D, Hirschfeld R, Goodwin F, et al. (1988) The NIMH depression awareness, recognition, and treatment program: structure, aims, and scientific basis. Am J Psychiatry 11:1351–1357Google Scholar
- 42.Harris KM, McKellar JD (June 2003) Demand for alcohol treatment. Frontlines: Linking Alcohol Services Research and Practice pp. 1–2. A publication of the National Institute on Alcohol Abuse and AlcoholismGoogle Scholar