Unfortunately, the trend toward under treating mental disorders is not limited to the USA. (2003) reported that only 52% of people diagnosed with major depressive disorder in the past 12 months received treatment and the treatment received was judged to be adequate in only 42% of cases. (2005) reported that approximately 60% of individuals with a mental disorder do not receive treatment and of those who do, only 32% of the treatments received fell into the ‘at least minimally adequate treatment’ category (p. A similar pattern of results is evident from the NCS-R. SAMHSA estimated that in 2007 fewer than half of the individuals who need mental health care are receiving the care they need ( SAMSHA, 2007). In sum, the evidence that has accrued across multiple studies conducted across multiple countries indicates that mental disorders are prevalent and that the number of people meeting diagnostic criteria for a mental disorder appears to be steeply growing. DALYs are the sum of years of life lost due to premature mortality and years lived with disability ( Murray & Lopez, 1997). Although we need to keep in mind the limitations inherent to comparing two cross sectional studies, the results from the Global Burden of Disease study suggests that from 1990 to 2010 the disability-adjusted life years (DALYs) associated with ‘mental and behavioral disorders’ increased by approximately 36% ( Murray et al., 2013). In terms of children and adolescents, an Institute of Medicine and National Research Council meta-analysis of over 50 studies from community samples across the world reported a prevalence rate of 17% for one or more mental, emotional, or behavioral disorder in youth, and about half reported significant functional impairment ( O’Connell, Boat, & Warner, 2009). Similarly, a meta-analysis of 27 studies including over 150,000 people from 16 European countries estimated that about 27% of people were diagnosed with at least one mental disorder within the past 12 months ( Wittchen & Jacobi, 2005). The results indicate that the global pattern is for high rates of mental disorder, although there was some variability with lower rates in Asian countries ( Demyttenaere et al., 2013). A crossnational study conducted by the World Health Organization (WHO) included 6 less developed countries and 8 developed countries. Forty percent of these individuals also had a comorbid mental disorder. An additional 20.7 million adults were diagnosed with a substance use disorder. In 2010, and involving 68,309 individuals in the USA aged 12 and older, the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (2012) reported that 18.6% of adults had a mental disorder, excluding a substance problem, and 4.1% of adults had a serious mental disorder. (2005), 30% of people surveyed over a 12-month period, and 50% of the population over the lifespan, met diagnostic criteria for a mental disorder. According to the NCS-R, and reported by Kessler et al. The National Comorbidity Study (NCS, 1990–1992 n = 8,098 15–54 year olds) and its replication (NCS-R 2001–2003 n = 9,282 18+ year olds) are nationally representative surveys conducted in the United States of America (USA). The prevalence of mental disorder is high and growing We conclude that there is a need for people in our field to become more knowledgeable about, and get involved in, shaping public policy. Several relatively new concepts in the field will be discussed (implementation cliff, program drift, voltage drop and deployment treatment development) and we contrast America and England as examples of government-level processes that are in the process of major change with respect to EBPTs. In particular, we focus on the need to continue to work toward innovation in treatment development while also solving the difficulties relating to the dissemination of EBPTs. A range of solutions to each set of contributors is offered and domains for future research are highlighted. We seek to highlight modifiable barriers to these problems at the patient, therapist, treatment, organization and government-levels of analysis. ![]() While evidence-based psychological treatments (EBPTs) are effective single or adjunctive treatments for mental disorders, there is also evidence that access to these treatments is diminishing. The prevalence of mental disorders is high and appears to be growing, yet the majority of individuals who meet diagnostic criteria for a mental disorder are not able to access an adequate treatment.
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