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Mental disorders common in U.S., researchers find

The Orlando Sentinel
7.6.2005

By Robyn Shelton

Up to 26 percent of all U.S. adults struggled with mental illness in the past year, with half of them having initially suffered symptoms as children, according to new research Monday from Harvard University scientists.

They found most people did not seek treatment for the common conditions such as depression and anxiety that were tracked. But when people did get help, they usually waited about 10 years after their problems initially surfaced.

That lag time can be dangerous, said Ronald Kessler, a professor of health-care policy at Harvard who oversaw the survey of nearly 10,000 people. He said researchers found that three-fourths of those with mental disorders had symptoms before age 24. Half of them showed signs of trouble by age 14.

If untreated, mild problems in young people can escalate and lead to damage that can't be undone, Kessler said. Their lives can be shaped permanently by psychological problems that can keep them from finishing school, cause relationship problems or lead to drug addiction.

"Mental disorders are really the most important chronic conditions of youth in America," Kessler said. "Sadly, these early-onset disorders very seldom come to the attention of the treatment system unless they're very severe."

The findings, published Monday in the Archives of General Psychiatry, are based on a national survey on the prevalence and severity of mental disorders. The research was conducted from February 2001 through April 2003 with face-to-face interviews of 9,282 English-speaking adults chosen at random in 34 states.

The $20 million research project was funded in part by the National Institute of Mental Health and private organizations including the Robert Wood Johnson Foundation.

In the survey, people were asked a series of questions to determine whether they had symptoms of anxiety, mood and impulse-control disorders or substance-abuse problems in the past year. Those categories include conditions such as panic disorder, obsessive-compulsive disorder, depression, bipolar disorder, attention-deficit disorder and alcohol addiction.

Kessler said researchers did not include less common conditions such as schizophrenia and autism. In addition to looking at disorders themselves, researchers studied the level of treatment that people underwent.

In doing so, they documented some unsettling trends.

For starters, mental disorders are widely undertreated, Kessler said, with most people not getting care despite persistent or life-affecting symptoms. He said this is partly because of the lingering stigma of mental illnesses.

But even when people seek help, treatment may not be readily available for a number of reasons.

There simply aren't enough mental-health professionals in many communities. And where they do exist, some families can't afford care because private insurers don't cover mental-health services as extensively as other conditions.

Dr. Philip Wang, an assistant professor of psychiatry and medicine at Harvard Medical School, found that just one-third of people in treatment are getting care that meets minimum standards.

That makes it hard, he said, to push for more people to get into treatment because so many are not getting adequate help.

Wang said it's a paradox to try to get more people into treatment while acknowledging that the existing medical care is often poor.

"The answer is that the problem of undertreatment is multifaceted, and you have to address all the aspects of it if we're really going to help people."

He said mental-health professionals need to work simultaneously on improving care in their communities while combating the stigma and financial issues that keep people from getting help.

Kessler said people shouldn't give up without even trying.

"Consumers need to be aware that effective treatment is available . . . but they have to be active consumers and get some understanding of what's good care, what's not good care," Kessler said.

In Central Florida, mental-health professionals are pretty busy but not too overburdened to take on new patients, said Bob Decker, a licensed mental-health counselor with the Mental Health Association of Central Florida.

"I would say it certainly takes longer to get an appointment with a psychiatrist than it does your family physician," Decker said.

Decker said it can be hard to determine when someone's problems are serious enough to warrant treatment. But he added that red flags should go up if the person's behavior changes significantly. In kids or teens, signs of problems include dropping grades in school and withdrawal from activities and others.

The research also found:

Forty-six percent of all U.S. adults will suffer from some kind of mental disorder in their lifetimes, with the majority of the problems falling into the category of mood disorders such as depression.

Phobias and anxiety disorders are the most common mental-health problems in the United States, affecting about 18 percent of the population in the past year.

Mental disorders often come in clusters. Researchers found that 45 percent of people with one condition also had symptoms of one or more additional disorders.

Most mental-health problems in the past year were mild (40.4 percent) or moderate (37.3 percent), while 22.3 percent were classified as serious.

About 6 percent of the U.S. population is severely disabled by a mental illness.

Robyn Shelton can be reached at 407-420-5487 or rshelton@orlandosentinel.com.

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