Use of Mental Health Services
The study indicates that the U.S. mental health care system is not keeping up with the needs of consumers and that improvements are needed to speed initiation of treatment as well as enhance the quality and duration of treatment. For instance, over a 12-month period, 60 percent of those with a mental disorder got no treatment at all.

The good news is that the proportion of people who reported 12-month mental health service use is higher now — at 17 percent — than a decade ago in the baseline NCS survey, at 13 percent. The expansion was mainly in the general medical sector, with more primary care physicians providing psychiatric services.

People with mental or substance abuse disorders were more likely to get treatment from a primary care physician/nurse or other general medical doctor (22.8 percent), or from a non-psychiatrist mental health specialist (16 percent), such as a psychologist, social worker, or counselor, than from a psychiatrist (12 percent), though the survey did show that the adequacy of treatment — measured by number of visits — is best when provided by mental health practitioners. About 9.7 percent sought help from a counselor or spiritual advisor outside of a mental health setting; and 6.9 percent used a complementary-alternative source, such as a chiropractor or self-help group. This held true even for those with severe mood disorders. Traditionally underserved groups, such as the elderly, racial/ethnic minorities and those with low income or without insurance, had the greatest unmet need for treatment.

Future and Ongoing Efforts
The NIMH epidemiological research portfolio contains several related projects that are focused on mental disorders among adolescents and ethnic subgroups. These include 1) an arm of the NCS-R that is studying 10,000 youths; 2) the National Study of African American Life, with 6,000 participants; and 3) the National Study of Latino and Asian Americans, with 5,000 participants. Each of these, like the NCS-R, will provide information on diagnosis, medications, disability/impairment, and service use, drawing from nationally based samples.

An international perspective on these findings is also becoming available, as the study is part of a global initiative on the epidemiology of mental disorders in 28 countries, coordinated through the World Health Organization.

NIMH is part of the National Institutes of Health (NIH), the Federal Government's primary agency for biomedical and behavioral research. NIH is a component of the U.S. Department of Health and Human Services.