Abstract
BackgroundCommon mental disorders (CMDs) are highly prevalent and contribute significantly to the global burden of disease, yet there is evidence of a large treatment gap. We aimed to quantify this gap among young adults with symptoms of CMDs and examine the relationship between substance use and perceived need for care and mental health service utilization.MethodsIn a nationally representative, cross-sectional survey of young Swiss adults’ mental health and wellbeing, we assessed symptoms of anxiety, depression, and attention deficit hyperactivity disorder (ADHD) with widely used screening instruments and asked about participant suicidal ideation, suicide attempts, mental health-related quality of life, alcohol and drug use, perceived need for mental health care, and mental health service utilization. We used these variables to calculate the treatment gap and weighted all analyses according to the stratified sampling plan.ResultsAround a quarter of young adults screened positive for at least one CMD. Participants who screened positive for anxiety and/or depression reported significantly more suicidal ideation and lifetime suicide attempts and reported worse mental health-related quality of life than participants who did not screen positive for a disorder. Women’s prevalence of anxiety and depression symptoms was significantly higher than men’s, while men were more likely to report most types of risky drug use. Among those with a CMD, only around half perceived lifetime need for care, and less than 20% reported currently utilizing mental health services. Young adults with a CMD reporting risky weekly use of alcohol were less likely to be currently using services.ConclusionThe high prevalence of CMD symptoms could reflect a rising prevalence of these disorders mirroring increasing trends observed in other countries. To address the large treatment gap, interventions promoting mental health literacy and more research on additional barriers to inform further interventions are needed.
Highlights
Common mental disorders (CMDs) are highly prevalent and contribute significantly to the global burden of disease, yet there is evidence of a large treatment gap
In the context of international trends indicating the growing burden and increased prevalence of common mental disorders (CMDs) [15, 16], we aimed to estimate the prevalence of the CMDs depression and anxiety as well as attention deficit hyperactivity disorder (ADHD), risky substance use and the prevalence of perceived need for treatment, lifetime and current service utilization, and the treatment gap between those in need of professional health services and those who receive them among those diagnosed using a representative sample of young adults in Switzerland
Prevalence of CMD symptoms and risky substance use Our study found that a quarter of youth reported symptoms indicating the presence of at least one of the CMDs (Table 2)
Summary
Common mental disorders (CMDs) are highly prevalent and contribute significantly to the global burden of disease, yet there is evidence of a large treatment gap. CMDs constitute one of the leading causes of disability-adjusted life years (DALYs) [2], and CMDs’ global burden continues to grow over time [3]: by 2030, depression is predicted to become the leading cause of disability in high-income countries [4]. Despite the significant impact of CMDs, there is evidence that many people suffering from such disorders are never diagnosed or do not access timely and/or appropriate treatment; across the world, this treatment gap has been estimated at over 50%, meaning that more than half of the people who could benefit from services do not reach them [7, 8]. Even among severe cases of mental disorders, only around half ever receive mental health treatment [9]
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