Editorial: Treatment Gap in Mental Health Care

By Abramowitz, M. Z.; Greenberg, D. et al. | The Israel Journal of Psychiatry and Related Sciences, April 1, 2008 | Go to article overview

Editorial: Treatment Gap in Mental Health Care


Abramowitz, M. Z., Greenberg, D., Levav, I., The Israel Journal of Psychiatry and Related Sciences


In Israel, as in other parts of the world (1), not every person in need of mental health care receives it (2). Although not all individuals with a diagnosable disorder require care (3), many do and yet remain untreated. The obstacles to care reside in a triad of factors: attitudes of the potential user, family and community; availability, accessibility and cultural adequacy of the services; and openness to psychiatry and belief system of the enveloping culture (1, 3). Recognition of this treatment gap by all stakeholders is an essential first step to diminish the burden of disease of the mental disorders (4).

How large is the treatment gap in Israel? The Israel National Health Survey (INHS) showed a considerable treatment gap in the care of common psychiatric disorders among adults (2). Among the findings: there was a 9.7% one-year prevalence rate of combined anxiety and mood disorders among Israeli residents aged 21 and over, of whom 64% were untreated. Projected, this would result in approximately 281,000 individuals untreated nationwide.

The treatment gap is even wider in selected population groups, such as residents of what is commonly referred to as the "periphery" (northern and southern Israel, in contrast to the cities of the central region) where mental health services are less available. Levinson reported that while 6.0% and 6.6% of the population in Jerusalem and Tel Aviv, respectively, consulted services for a mental health problem during a 12-month period, the corresponding figures in the northern and southern districts were 3.9% and 4.1%, respectively (5). With regard to the young, "39.1% of mothers whose child had any mental disorder consulted a professional source in the preceding year concerning the emotional or behavioral problems of their child, while only one-third of their children who had any mental disorder consulted someone in school in the past year" (6). In the ArabIsraeli minority, the treatment gap with regard to anxiety and depressive disorders is twice as high as in the Jewish-Israeli population (7). This may result from a combination of the three sets of potential obstacles to care referred to earlier. Members of other minority groups (i.e., ultra-Orthodox Jews) may be under-users of services even when available, perhaps because of the limited fit between the respective "assumptive worlds" (8) of users and providers as discussed by Rosen et al. in a study of ultra-Orthodox referrals to a North Jerusalem community mental health center (9).

As a consequence of the treatment gap, many people may remain without proper care, facing continued suffering and disability. Often, the impact of the psychiatric disorder extends to family members and caregivers (1). Additionally, the instrumental burden is considerable, measured in terms of the direct costs (for example, needless laboratory tests in the primary care context when the psychiatric disorder is not recognized) and of indirect costs (e.g., days lost from work). The INHS found that the treatment gap was narrower when the disorder had the highest level of severity (2). This burden is compounded further by the higher prevalence rates of the common mental disorders of mild and moderate severity, since they are characterized by a relatively higher treatment gap than the prior group. These findings are not confined to Israel. Other countries that carried out similar surveys under the coordination of Harvard University and the World Health Organization have reported similar findings (2).

The stigma attached to mental disorders and psychiatric services has been recognized as one of the factors present in the individual, family and community that prevent or delay mental health consultations. This issue of the Israel Journal of Psychiatry reports the results of a study on the attitudes of the Israeli public towards psychiatric disorders and the preferred site for mental health care (10).

The combined findings of two recent community-based studies, the INHS, that explored the gap between people with diagnosable disorders and those actually treated (2), and the paper by Struch et al. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Editorial: Treatment Gap in Mental Health Care
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.