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

Background
There is a high unmet need for mental health treatment worldwide. Understanding the barriers to treatment is essential for developing effective programs to address this issue.

Methods
Data on treatment barriers were collected through face-to-face interviews in 22 community surveys across 19 countries, involving 102,812 respondents aged 18 and older. The focus was on 5,136 individuals with anxiety, mood, or substance use disorders who had a perceived need for treatment. Of these, 2,444 did not receive treatment, and 926 received delayed treatment. Barriers were categorized into five broad classes: low perceived disorder severity, beliefs/attitudes about treatment ineffectiveness, stigma, financial barriers, and nonfinancial enabling factors. Predictors of treatment receipt and barriers were analyzed.

Results
Most respondents reported multiple barriers. For those who did not receive treatment, common barriers included low perceived severity (52.9%), perceived treatment ineffectiveness (44.8%), financial (32.9%) and nonfinancial (40.2%) barriers, and stigma (20.6%). Barriers for those with delayed treatment were similar but reported by higher proportions. Barriers were predicted by factors such as low education, disorder type, age, employment status, and financial challenges, with predictors varying depending on the barrier type.

Conclusions
A wide range of barriers exist even for individuals who acknowledge the need for mental health treatment, with most facing multiple challenges. These findings have important implications for designing programs aimed at reducing unmet treatment needs for mental disorders.