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January 2002, Vol 92, No. 1 | American Journal of Public Health 92-98
© 2002 American Public Health Association

RESEARCH AND PRACTICE

Adequacy of Treatment for Serious Mental Illness in the United States

Philip S. Wang, MD, DrPH, Olga Demler, MS and Ronald C. Kessler, PhD

The authors are with the Department of Health Care Policy, Harvard Medical School, Boston, Mass. Philip S. Wang is also with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School.

Correspondence: Requests for reprints should be sent to Philip S. Wang, MD, DrPH, Department of Health Care Policy, 180 Longwood Ave, Boston, MA 02115 (e-mail: pwang{at}rics.bwh.harvard.edu).

Objectives. The purpose of this study was to assess the prevalence and correlates of treatment for serious mental illness.

Methods. Data were derived from the National Comorbidity Survey, a cross-sectional, nationally representative household survey assessing the presence and correlates of mental disorders and treatments. Crude and adjusted likelihoods of receiving treatment for serious mental illness in the previous 12 months were calculated.

Results. Forty percent of respondents with serious mental illness had received treatment in the previous year. Of those receiving treatment, 38.9% received care that could be considered at least minimally adequate, resulting in 15.3% of all respondents with serious mental illness receiving minimally adequate treatment. Predictors of not receiving minimally adequate treatment included being a young adult or an African American, residing in the South, being diagnosed as having a psychotic disorder, and being treated in the general medical sector.

Conclusions. Inadequate treatment of serious mental illness is an enormous public health problem. Public policies and cost-effective interventions are needed to improve both access to treatment and quality of treatment.




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