Cross-national data from 15 countries show varying access to quality treatment for PTSD

The authors of this article wrote it on behalf of themselves and their fellow collaborators on the World Health Organization’s World Mental Health (WMH) Survey Initiative, which coordinates a set of community psychiatric epidemiological surveys conducted in 30 countries. Since mental and addictive disorders are increasing worldwide, the WMH Survey Initiative aims to obtain accurate cross-national information about them and their treatment. WMH surveys use trained interviewers who utilize the WHO Composite International Diagnostic Interview (CIDI) to assess mental disorders, including posttraumatic stress disorder (PTSD), which is the focus of this article. Stein et al. note that there has been progress in the quality of treatment available for PTSD, but even though good drug therapy and psychotherapy are available, not all people who need it get adequate help. Stein et al. examined levels of treatment adequacy and coverage for PTSD using a cross-national dataset that combined data gathered from adults in 17 different WMH surveys in nine high-income and six low- and middle-income countries. The single US survey in their dataset was the National Comorbidity Survey Replication (NCS-R), a nationally representative survey of adults in the US from 2001 to 2003. NCS-R data are available from ICPSR’s General Archive via the study, Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003 [United States] (ICPSR 20240).

Stein et al. found that of the 35,012 respondents they evaluated, 914 met DSM-IV criteria for 12-month PTSD. And many of those individuals with PTSD do not receive adequate treatment, with only 43 percent accessing mental health services and even fewer receiving pharmacotherapy or psychotherapy. The study also highlighted that treatment coverage was higher in high-income countries compared to low- and middle-income countries. Lack of insurance and having mild clinical symptoms were the two biggest predictors of getting less effective treatment for PTSD. The study emphasized the need for improved access to mental health services and the importance of universal health care coverage for both physical and mental disorders.