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This Article Figures Only Full Text Full Text (PDF) Spanish Abstract All Versions of this Article: AJPH.2006.090985v1 97/9/1638    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Borges, G. Articles by Chiu, W. T. Search for Related Content PubMed PubMed Citation Articles by Borges, G. Articles by Chiu, W. T. Related Collections Epidemiology Access to Care Mental Health Hispanics/Latinos Alcohol Drugs

Guilherme Borges, ScD, Philip S. Wang, MD, PhD, Maria Elena Medina-Mora, PhD, Carmen Lara, MD and Wai Tat Chiu, MA

Guilherme Borges is with the National Institute of Psychiatry and the Metropolitan Autonomous University, Mexico City, Mexico. Maria Elena Medina-Mora is with the National Institute of Psychiatry, Mexico City. Carmen Lara is with the National Institute of Psychiatry and the Puebla Autonomous University, Puebla, Mexico. Philip S. Wang and Wai Tat Chiu are with the Department of Health Care Policy, Harvard Medical School, Boston, Mass.

Correspondence: Requests for reprint should be sent to Guilherme Borges, Instituto Nacional de Psiquiatria, Calzada Mexico Xochimilco No 101- Col. San Lorenzo Huipulco, Mexico D.F. C.P.14370, Mexico (e-mail: guibor{at}imp.edu.mx).

Objectives. We studied failure and delay in making initial treatment contact after the first onset of a mental or substance use disorder in Mexico as a first step to understanding barriers to providing effective treatment in Mexico.

Methods. Data were from the Mexican National Comorbidity Survey (2001–2002), a representative, face-to-face household survey of urban residents aged 18 to 65 years. The age of onset for disorders was compared with the age of first professional treatment contact for each lifetime disorder (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).

Results. Many people with lifetime disorders eventually made treatment contact, although the proportions varied for mood (69.9%), anxiety (53.2%), and substance use (22.1%) disorders. Delays were long: 10 years for substance use disorders, 14 years for mood disorders, and 30 years for anxiety disorders. Failure and delay in making initial treatment contact were associated with earlier ages of disorder onset and being in older cohorts.

Conclusions. Failure to make prompt initial treatment contact is an important reason explaining why there are unmet needs for mental health care in Mexico. Meeting these needs will likely require expansion and optimal allocation of resources as well as other interventions.