Drop out from out-patient mental healthcare in the World Health Organization's World Mental Health Survey initiative

Br J Psychiatry. 2013 Jan;202(1):42-9. doi: 10.1192/bjp.bp.112.113134. Epub 2012 Nov 22.

Abstract

Background: Previous community surveys of the drop out from mental health treatment have been carried out only in the USA and Canada.

Aims: To explore mental health treatment drop out in the World Health Organization World Mental Health Surveys.

Method: Representative face-to-face household surveys were conducted among adults in 24 countries. People who reported mental health treatment in the 12 months before interview (n = 8482) were asked about drop out, defined as stopping treatment before the provider wanted.

Results: Overall, drop out was 31.7%: 26.3% in high-income countries, 45.1% in upper-middle-income countries, and 37.6% in low/lower-middle-income countries. Drop out from psychiatrists was 21.3% overall and similar across country income groups (high 20.3%, upper-middle 23.6%, low/lower-middle 23.8%) but the pattern of drop out across other sectors differed by country income group. Drop out was more likely early in treatment, particularly after the second visit.

Conclusions: Drop out needs to be reduced to ensure effective treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data*
  • Comorbidity
  • Demography
  • Global Health / statistics & numerical data
  • Health Services Needs and Demand
  • Health Surveys
  • Humans
  • Income
  • Interview, Psychological
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Dropouts / statistics & numerical data*
  • Survival Analysis
  • World Health Organization
  • Young Adult