Prevalence and predictors of no lifetime utilization of mental health treatment among people with mental disorders in France: findings from the ‘Mental Health in General Population’ (MHGP) survey
No lifetime utilization of mental health treatment (NUMT) is an indicator of the treatment gap among people in need of treatment. Until now, the overall prevalence and predictors of NUMT have never been explored in France.
In a 39,617-respondent survey, participants were assessed for NUMT, i.e., no lifetime psychotherapy, psychopharmacotherapy, or psychiatric hospitalization. Mental disorders were investigated using the Mini International Neuropsychiatric Interview (MINI 5.0.0). MINI diagnoses were grouped into five categories: mood disorders (MDs); anxiety disorders (ADs); alcohol use disorders (AUDs); substance use disorders (SUDs); and psychotic disorders (PDs). Using multivariable logistic regression models, we explored the factors associated with NUMT among the MINI-positive respondents. The odds ratio and 95% confidence interval were calculated for each factor.
In total, 12,818 (32.4%) respondents were MINI-positive, 46.5% of them reported NUMT (35.6% for MDs, 39.7% for PDs, 42.8% for ADs, 56.0% for AUDs, and 56.7% for SUDs). NUMT was positively associated with being male [OR 1.75 (1.59–1.91)] and practising religion [OR 1.13 (1.02–1.25)] and negatively associated with ageing [per 10-year increase: OR 0.88 (0.85–0.91)], being single [OR 0.74 (0.66–0.84)], being a French native [OR 0.67 (0.60–0.75)], and experiencing MDs [OR 0.39 (0.36–0.43)], ADs [OR 0.47 (0.43–0.52)], AUDs [OR 0.83 (0.73–0.96)], SUDs [OR 0.77 (0.65–0.91)], or PDs [OR 0.50 (0.43–0.59)].
In France, NUMT rates were the highest for AUDs and SUDs. Additionally, suffering from MDs or ADs increased the lifetime treatment utilization for people having any other mental disorder. This finding emphasizes the need to better screen AUDs and SUDs among people treated for MDs or ADs.
KeywordsMental health Treatment utilization Epidemiology France
The MHGP survey was funded by the French Ministry for Health. The work undertaken in this study was funded by a Grant from the Fondation Actions-Addictions (https://www.actions-addictions.org), which is an independent non-profit foundation promoting evidence-based action against addiction in France.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Knapp M, McDaid D, Mossialos E, Thornicroft G (2014) Mental health policy and practice across Europe. The future direction of mental health care. World Health Organization, GenevaGoogle Scholar
- 9.Bellamy V, Roelandt J-L, Caria A (2004) Troubles mentaux et représentations de la santé mentale: premiers résultats de l’enquête Santé Mentale en Population Générale. DREES 347:1–12Google Scholar
- 18.Compton WM, Thomas YF, Stinson FS, Grant BF (2007) Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 64:566–576. https://doi.org/10.1001/archpsyc.64.5.566 CrossRefPubMedGoogle Scholar
- 25.Davis LL, Wisniewski SR, Howland RH et al (2010) Does comorbid substance use disorder impair recovery from major depression with SSRI treatment? An analysis of the STARD level one treatment outcomes. Drug Alcohol Depend 107:161–170. https://doi.org/10.1016/j.drugalcdep.2009.10.003 CrossRefPubMedGoogle Scholar
- 26.Howland RH, John Rush A, Wisniewski SR et al (2009) Concurrent anxiety and substance use disorders among outpatients with major depression: clinical features and effect on treatment outcome. Drug Alcohol Depend 99:248–260. https://doi.org/10.1016/j.drugalcdep.2008.08.010 CrossRefPubMedGoogle Scholar
- 33.Choi NG, DiNitto DM, Marti CN (2014) Treatment use, perceived need, and barriers to seeking treatment for substance abuse and mental health problems among older adults compared to younger adults. Drug Alcohol Depend 145:113–120. https://doi.org/10.1016/j.drugalcdep.2014.10.004 CrossRefPubMedGoogle Scholar
- 34.Nobles CJ, Valentine SE, Gerber MW et al (2016) Predictors of treatment utilization and unmet treatment need among individuals with posttraumatic stress disorder from a national sample. Gen Hosp Psychiatry 43:38–45. https://doi.org/10.1016/j.genhosppsych.2016.09.001 CrossRefPubMedPubMedCentralGoogle Scholar
- 36.Bellido-Zanin G, Ángeles Pérez-San-Gregorio M, Martín-Rodríguez A, Vázquez-Morejón AJ (2015) Social functioning as a predictor of the use of mental health resources in patients with severe mental disorder. Psychiatry Res 230:189–193. https://doi.org/10.1016/j.psychres.2015.08.037 CrossRefPubMedGoogle Scholar