Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan

Anthony F Jorm,Kathleen M Griffiths,Helen Christensen,Yoshibumi Nakane,Yuji Wata,Kumiko Yoshioka

doi:10.1186/1741-7015-3-12

Abstract

BackgroundSurveys of the public in a number of countries have shown poor recognition of mental disorders and beliefs about treatment that often diverge from those of health professionals. This lack of mental health literacy can limit the optimal use of treatment services. Australia and Japan are countries with very different mental health care systems, with Japan emphasising hospital care and Australia more oriented to community care. Japan is also more collectivist and Australia more individualist in values. These differences might influence recognition of disorders and beliefs about treatment in the two countries.MethodsSurveys of the public were carried out in each country using as similar a methodology as feasible. In both countries, household interviews were carried out concerning beliefs in relation to one of four case vignettes, describing either depression, depression with suicidal thoughts, early schizophrenia or chronic schizophrenia. In Australia, the survey involved a national sample of 3998 adults aged 18 years or over. In Japan, the survey involved 2000 adults aged between 20 and 69 from 25 regional sites spread across the country.ResultsThe Japanese public were found to be more reluctant to use psychiatric labels, particularly for the depression cases. The Japanese were also more reluctant to discuss mental disorders with others outside the family. They had a strong belief in counsellors, but not in GPs. They generally believe in the benefits of treatment, but are not optimistic about full recovery. By contrast, Australians used psychiatric labels more often, particularly "depression". They were also more positive about the benefits of seeking professional help, but had a strong preference for lifestyle interventions and tended to be negative about some psychiatric medications. Australians were positive about both counsellors and GPs. Psychiatric hospitalization and ECT were seen negatively in both countries.ConclusionThere are some major differences between Australia and Japan in recognition of disorders and beliefs about treatment. Some of these may relate to the different health care systems, but the increasing openness about mental health in Australia is also likely to be an explanatory factor.

Highlights

Surveys of the public in a number of countries have shown poor recognition of mental disorders and beliefs about treatment that often diverge from those of health professionals
There are many factors that affect this unmet need for treatment. One of these is a lack of mental health literacy on the part of the public, a lack of knowledge of how to recognise mental disorders and beliefs about treatment that are at variance with those of health professionals [2]
It is known that GPs are more likely to detect a mental disorder if the patient presents the symptoms in psychological rather than somatic terms [9,10], and if the patient explicitly raises the possibility of a mental disorder with the GP [11,12]

Summary

Introduction

Surveys of the public in a number of countries have shown poor recognition of mental disorders and beliefs about treatment that often diverge from those of health professionals. This lack of mental health literacy can limit the optimal use of treatment services. There are many factors that affect this unmet need for treatment One of these is a lack of mental health literacy on the part of the public, a lack of knowledge of how to recognise mental disorders and beliefs about treatment that are at variance with those of health professionals [2]. It is known that GPs are more likely to detect a mental disorder if the patient presents the symptoms in psychological rather than somatic terms [9,10], and if the patient explicitly raises the possibility of a mental disorder with the GP [11,12]

Methods

Results

Conclusion