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Frequency and quality of mental health treatment for affective and anxiety disorders among Australian adults

Med J Aust 2015; 202 (4): 185-189. || doi: 10.5694/mja14.00297

Summary

Objectives: To describe the frequency, type and quality of mental health treatment among Australian adults with past-year affective and/or anxiety disorders.

Design, setting and participants: Retrospective analysis of data for 8831 adults aged 16–85 years interviewed for the 2007 National Survey of Mental Health and Wellbeing, of whom 17% (n = 1517) met International Classification of Diseases, 10th revision (ICD-10) criteria for a past-year affective and/or anxiety disorder.

Main outcome measures: Three levels of mental health treatment received in the past year: (1) any consultation with a health professional for mental health; (2) any evidence-based intervention (antidepressant medication, mood stabiliser medication, cognitive behaviour therapy and/or psychotherapy); and (3) minimally adequate treatment (a “dose” of an evidence-based intervention above a minimum threshold, consistent with treatment guidelines).

Results: Of participants with past-year affective and/or anxiety disorders, 39% sought professional help for mental health, 26% received an evidence-based treatment, and 16% received minimally adequate treatment. After controlling for clinical factors including type and severity of disorder, the odds of all levels of treatment were lower among younger adults (16–29 years) compared with middle-aged adults, and the odds of receiving an evidence-based treatment or minimally adequate treatment were lower among people who consulted a general practitioner only compared with a mental health professional.

Conclusions: Closing the gap in treatment quality requires strategies to increase the use of evidence-based interventions, and to ensure these are delivered in sufficient doses. Research to elucidate why some patients are at increased risk of inadequate treatment, and the aspects of treatment that contribute to inadequate care, is indicated.

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  • Meredith G Harris1,2
  • Megan J Hobbs3
  • Philip M Burgess1
  • Jane E Pirkis4
  • Sandra Diminic1,0,0,2
  • Dan J Siskind1,0,5
  • Gavin Andrews6
  • Harvey A Whiteford1,0,0,2

  • 2 Queensland Centre for Mental Health Research, Brisbane, QLD.
  • 3 University of New South Wales, Sydney, NSW.
  • 4 University of Melbourne, Melbourne, VIC.
  • 5 Metro South Addiction and Mental Health Service, Brisbane, QLD.
  • 6 St Vincent's Hospital, Sydney, NSW.
  • 1 University of Queensland, Brisbane, QLD

Correspondence: harrism@qcmhr.uq.edu.au

Acknowledgements: 

This project was supported by the Australian Centre for Health Services Innovation (grant SG0005-000169) and the National Health and Medical Research Council Centre of Research Excellence in Mental Health Systems Improvement (APP1041131).

Competing interests:

No relevant disclosures.

  • 1. Slade T, Johnston A, Oakley Browne MA, et al. 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Aust N Z J Psychiatry 2009; 43: 594-605.
  • 2. Institute for Health Metrics and Evaluation. GBD Compare. Global, DALYs: both sexes, all ages, 2010. Seattle, Wash: University of Washington, 2013. http://viz.healthmetricsandevaluation.org/gbd-compare (accessed Dec 2013).
  • 3. Andrews G, Issakidis C, Sanderson K, et al. Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders. Br J Psychiatry 2004; 184: 526-533.
  • 4. Meadows G, Liaw T, Burgess P, et al. Australian general practice and the meeting of needs for mental health care. Soc Psychiatry Psychiatr Epidemiol 2001; 36: 595-603.
  • 5. Parslow RA, Jorm AF. Who uses mental health services in Australia? An analysis of data from the National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2000; 34: 997-1008.
  • 6. Parslow RA, Jorm AF. Predictors of types of help provided to people using services for mental health problems: an analysis of the Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2001; 35: 183-189.
  • 7. Issakidis C, Andrews G. Who treats whom? An application of the Pathways to Care model in Australia. Aust N Z J Psychiatry 2006; 40: 74-86.
  • 8. Issakidis C, Andrews G. Service utilisation for anxiety in an Australian community sample. Soc Psychiatry Psychiatr Epidemiol 2002; 37: 153-163.
  • 9. Jorm A. The population impact of improvements in mental health services: the case of Australia. Br J Psychiatry 2011; 199: 443-444.
  • 10. Burgess PM, Pirkis JE, Slade TN, et al. Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2009; 43: 615-623.
  • 11. Meadows GN, Bobevski I. Changes in met perceived need for mental healthcare in Australia from 1997 to 2007. Br J Psychiatry 2011; 199: 479-484.
  • 12. Wang PS, Lane M, Olfson M, et al. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 629-640.
  • 13. Young AS, Klap R, Sherbourne CD, Wells KB. The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry 2001; 58: 55-61.
  • 14. Duhoux A, Fournier L, Nguyen CT, et al. Guideline concordance of treatment for depressive disorders in Canada. Soc Psychiatry Psychiatr Epidemiol 2009; 44: 385-392.
  • 15. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: users' guide, 2007. Canberra: Australian Bureau of Statistics, 2009. (ABS Cat. No. 4327.0.) http://www.abs.gov.au/ausstats/abs@.nsf/mf/4327.0 (accessed Oct 2014).
  • 16. Pirkis J, Harris M, Hall W, Ftanou M. Evaluation of the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule Initiative: summative evaluation. Melbourne: Centre for Health Policy, Programs and Economics, University of Melbourne, 2011. http://www.ozfoodnet.gov.au/internet/main/publishing.nsf/Content/5F330C940AFDB767CA257BF0001DE702/$File/sum.pdf (accessed Oct 2014).
  • 17. Cuijpers P, Huibers M, Ebert DD, et al. How much psychotherapy is needed to treat depression? A metaregression analysis. J Affect Disord 2013; 149: 1-13.
  • 18. Duhoux A, Fournier L, Gauvin L, Roberge P. What is the association between quality of treatment for depression and patient outcomes? A cohort study of adults consulting in primary care. J Affect Disord 2013; 151: 265-274.
  • 19. Simon GE, Von Korff M, Rutter CM, Peterson DA. Treatment process and outcomes for managed care patients receiving new antidepressant prescriptions from psychiatrists and primary care physicians. Arch Gen Psychiatry 2001; 58: 395-401.
  • 20. Andrews G, Cuijpers P, Craske MG, et al. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLOS One 2010; 5: e13196.
  • 21. Williams AD, Andrews G. The effectiveness of internet cognitive behavioural therapy (iCBT) for depression in primary care: a quality assurance study. PLOS One 2013; 8: e57447.
  • 22. Burton C, Anderson N, Wilde K, Simpson CR. Factors associated with duration of new antidepressant treatment: analysis of a large primary care database. Br J Gen Pract 2012; 62: e104-e112.
  • 23. Britt H, Miller GC, Charles J, et al. General practice in Australia, health priorities and policies 1998 to 2008. Canberra: Australian Institute of Health and Welfare, 2009. (AIHW Cat. No. GEP 24.) http://www.aihw.gov.au/publication-detail/?id=6442468257 (accessed Oct 2014).
  • 24. Duhoux A, Fournier L, Gauvin L, Roberge P. Quality of care for major depression and its determinants: a multilevel analysis. BMC Psychiatry 2012; 12: 142.
  • 25. Whiteford HA, Buckingham WJ, Harris MG, et al. Estimating treatment rates for mental disorders in Australia. Aust Health Rev 2014; 38: 80-85.

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