A large percentage of people with clinically recognized levels of mental health symptoms do not receive treatment. In the psychological arena, these individuals are considered in need of treatment. However, debate has arisen over whether these individuals should be included in estimates of those in need of mental health treatment.
The controversy has been fueled by mixed data suggesting that many people who meet the criteria for mental issues unrelated to psychosis achieve remission without treatment. If this data is true, should people with clinical symptoms and diagnoses of some mental health conditions avoid treatment, or would they benefit from it?
Jitender Sareen of the Departments of Psychiatry, Psychology, and Community Health Sciences at the University of Manitoba in Winnipeg, Canada made that question the center of a recent study. Sareen examined data from over 34,000 adults to determine level of symptom severity, mental healthcare use, suicidal tendencies and overall health quality of life (QoL) over a three year period. Sareen looked specifically at participants with depression, anxiety, and/or substance use (DAS) problems.
The results revealed that the participants who never received mental healthcare treatment had much higher rates of remission over the three years than those who received treatment. Additionally, they had fewer comorbid mental health issues and fewer suicide attempts. At the end of the three years, Sareen found that the remitted, nontreated participants functioned similarly to those who did not have a DAS issue at all.
“Together,” said Sareen, “These findings suggest that epidemiologic studies demonstrating a high prevalence of untreated mental disorders in the community might be overestimating the need for mental health services.” But these results should be interpreted with caution for several reasons.
First, many of the individuals who remitted may have remitted sooner with treatment, a theory that should be investigated in future work. Second, environmental and personal life stressors were not measured in this study. These factors could significantly increase symptom severity. Third, even though many who did not receive treatment achieved remission, their overall QoLs were much lower than those who never had DAS problems.
This suggests that perhaps QoL could be improved and remission levels retained or improved with the addition of mental health treatment for individuals with DAS conditions. These considerations should be examined in depth in future work to better capture the impact of treatment on remission for people with nonpsychotic psychological issues.
Sareen, J., et al. (2013). Common mental disorder diagnosis and need for treatment are not the same: Findings from a population-based longitudinal survey. Psychological Medicine 43.9 (2013): 1941-51. ProQuest. Web.
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