April 29, 2025

Across 21 countries, 6.9% of people with behavioral health disorders in 2001 through 2019 received effective treatment, defined as treatment contact for their mental health or addiction disorder, plus pharmacotherapy and/or counseling. Anxiety (7.3%) and mood disorders (8.4%) were much more likely to receive effective treatment than addiction disorders (1.7%).

For this analysis, adequate treatment for disorders with mild-to-moderate severity had the following components:

• Minimally adequate pharmacotherapy: Any medication with adequate medication control for at least four visits with a physician over 12 months or still in treatment after two sessions. For major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic/agoraphobia, specific phobia, and social phobia, effective pharmacotherapy was defined as taking an antidepressant with adequate medication control and adherence.
• Minimally adequate counseling: At least eight sessions with any clinical professional over 12 months, or still in treatment after two sessions.
• For bipolar disorder and other severe conditions, effective treatment was defined as both minimally adequate pharmacotherapy and effective psychotherapy.

Most people who sought help (82.9%) received a minimum level of adequate treatment. About 47% of those who received the minimally adequate treatment ended up receiving effective treatment.

The largest barrier to effective treatment was a person not recognizing they need treatment (low perceived need: 46.5%). However, even those who sought treatment often did not receive effective treatment (34.1%).

These findings were presented in “Effective Treatment for Mental and Substance Use Disorders in 21 Countries,” by Daniel V. Vigo, M.D., DrPH; Dan J. Stein, M.D., Ph.D.; Meredith G. Harris, MPH, Ph.D.; Alan E. Kazdin, Ph.D.; and colleagues. The researchers analyzed data from the World Mental Health (WMH) surveys from nearly 57,000 participants in 21 countries collected over 19 years between 2001 and 2019. A total of a weighted sample of 56,927 of the total 117,739 responses were used for analysis. The goal was to analyze where people discontinue their path to effective treatment for nine common anxiety, mood, and addiction disorders.

They analyzed four key steps, and the percentage of people who proceeded from each step to the next:

1. Recognize their need for treatment
2. Make contact with the health care system about the need for treatment
3. Receives a minimum level of adequate treatment
4. Receives effective treatment

The full text of Effective Treatment for Mental and Substance Use Disorders in 21 Countries was published February 5, 2025, by JAMA Psychiatry. A free abstract is available online at https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2829593 (accessed April 24, 2025).

For more information, contact: Daniel V. Vigo, M.D., DrPH, Associate Professor, Department of Psychiatry, University of British Columbia, UBC Hospital, 2255 Wesbrook Mall, Detwiller Pavilion, Room 2813, Vancouver, British Columbia, Canada V6T 2B8; Email: daniel.vigo@ubc.ca; Website: https://psychiatry.ubc.ca/daniel-vigo/