Harris Meredith G, Kazdin Alan E, Hwang Irving, Manoukian Sophie M, Sampson Nancy A, Stein Dan J, Viana Maria Carmen, Vigo Daniel V, Alonso Jordi, Andrade Laura Helena, Bruffaerts Ronny, Bunting Brendan, Caldas-de-Almeida José Miguel, Chardoul Stephanie, de Girolamo Giovanni, Gureje Oye, Haro Josep Maria, Karam Elie G, Kovess-Masfety Viviane, Medina-Mora Maria Elena, Navarro-Mateu Fernando, Nishi Daisuke, Posada-Villa José, Rapsey Charlene, Stagnaro Juan Carlos, Ten Have Margreet, Wciórka Jacek, Zarkov Zahari, Kessler Ronald C
School of Public Health, The University of Queensland, c/o QCMHR, Locked Bag 500, Archerfield, QLD, 4108, Australia.
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wolston Park Rd, Wacol, QLD, 4076, Australia.
Int J Ment Health Syst. 2025 May 23;19(1):17. doi: 10.1186/s13033-025-00666-w.
Perceived need for treatment is a first step along the pathway to effective mental health treatment. Perceived need encompasses a person's recognition that they have a problem and their belief that professional help is needed to manage the problem. These two components could have different predictors.
Respondents aged 18+ years with 12-month mental disorders from 25 representative household surveys in 21 countries in the World Mental Health Survey Initiative (n = 12,508). All surveys included questions about perceived need; 16 surveys (13 countries) included additional questions about respondents' main reason for perceived need-problem recognition or perceived inability to manage without professional help (n = 9814). Associations of three sets of predictors (disorder, socio-demographics, past treatment) with perceived need and its components were examined using Poisson regression models.
Across the 16 surveys with additional questions, 42.4% of respondents with a 12-month mental disorder reported perceived need for treatment. In separate multivariable models for each predictor set: (1) Most disorder types (except alcohol use disorder, specific phobia), disorder severity, and number of disorders were associated with perceived need and both of its components; (2) Sociodemographic factors tended to differentially predict either problem recognition (females, 30-59 years, disabled/unemployed) or need for professional help (females, homemakers, disabled/unemployed, public insurance); (3) Past treatment factors (type of professional, psychotherapy, helpful or unhelpful treatment) were associated with perceived need and both components, except number of past professionals differentially predicted problem recognition. In a consolidated model: employment and insurance became non-significant; type and number of past professionals seen became more important; helpful past treatment predicted greater need for professional help while unhelpful treatment predicted lower problem recognition. Problem recognition was the more important component in determining perceived need for some groups (e.g., severe disorder, people who consulted non-mental health professionals).
Greater clinical need is a key determinant of perceived need for treatment. Findings suggest a need for strategies to address low perceived need (e.g., in males, older people, alcohol use disorders) and lower endorsement of professional treatment in some groups, and to improve patient's treatment experiences which are important enablers of future help-seeking.
感知到的治疗需求是通向有效心理健康治疗途径的第一步。感知到的需求包括一个人认识到自己有问题，以及他们认为需要专业帮助来解决问题。这两个组成部分可能有不同的预测因素。
来自世界心理健康调查倡议中21个国家的25项代表性家庭调查的18岁及以上有12个月精神障碍的受访者（n = 12508）。所有调查都包括关于感知到的需求的问题；16项调查（13个国家）包括关于受访者感知到的需求的主要原因的额外问题——问题识别或认为没有专业帮助就无法解决（n = 9814）。使用泊松回归模型研究了三组预测因素（障碍、社会人口统计学、过去的治疗）与感知到的需求及其组成部分之间的关联。
在有额外问题的16项调查中，42.4%有12个月精神障碍的受访者报告有治疗需求。在针对每个预测因素集的单独多变量模型中：（1）大多数障碍类型（除酒精使用障碍、特定恐惧症）、障碍严重程度和障碍数量与感知到的需求及其两个组成部分都相关；（2）社会人口统计学因素倾向于分别预测问题识别（女性、30 - 59岁、残疾/失业）或对专业帮助的需求（女性、家庭主妇、残疾/失业、公共保险）；（3）过去的治疗因素（专业类型、心理治疗、有帮助或无帮助的治疗）与感知到的需求及其两个组成部分都相关，除了过去见过的专业人员数量分别预测问题识别。在一个综合模型中：就业和保险变得不显著；过去见过的专业人员的类型和数量变得更重要；过去有帮助的治疗预测对专业帮助的更大需求，而无帮助的治疗预测较低的问题识别。对于某些群体（例如，严重障碍、咨询非心理健康专业人员的人），问题识别是决定感知到的治疗需求的更重要组成部分。
更大的临床需求是感知到的治疗需求的关键决定因素。研究结果表明需要采取策略来解决感知到的需求较低的问题（例如，男性、老年人、酒精使用障碍患者）以及某些群体对专业治疗的认可度较低的问题，并改善患者的治疗体验，这是未来寻求帮助的重要推动因素。
