1. Dropout from treatment for mental disorders in six countries of the Americas: A regional report from the World Mental Health Surveys.
- Author
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Benjet C, Borges G, Orozco R, Aguilar-Gaxiola S, Andrade LH, Cia A, Hwang I, Kessler RC, Piazza M, Posada-Villa J, Sampson N, Stagnaro JC, Torres Y, Viana MC, Vigo D, and Medina-Mora ME
- Subjects
- Brazil, Health Surveys, Humans, Surveys and Questionnaires, Mental Disorders epidemiology, Mental Disorders therapy, Mental Health Services
- Abstract
Objective: To estimate structural and attitudinal reasons for premature discontinuation of mental health treatment, socio-demographic and clinical correlates of treatment dropout due to these reasons, and to test country differences from the overall effect across the region of the Americas., Methods: World Health Organization-World Mental Health (WMH) surveys were carried out in six countries in the Americas: Argentina, Brazil, Colombia, Mexico, Peru and USA. Among the 1991 participants who met diagnostic criteria (measured with the Composite International Diagnostic Interview (WMHCIDI)) for a mental disorder and were in treatment in the prior 12-months, the 236 (12.2%) who dropped out of treatment before the professional recommended were included., Findings: In all countries, individuals more frequently reported attitudinal (79.2%) rather than structural reasons (30.7%) for dropout. Disorder severity was associated with structural reasons; those with severe disorder (versus mild disorder) had 3.4 (95%CI=1.1-11.1) times the odds of reporting a structural reason. Regarding attitudinal reasons, those with lower income (versus higher income) were less likely to discontinue treatment because of getting better (OR=0.4; 95%CI= 0.2-0.9). Country specific variations were found., Limitations: Not all countries, or the poorest, in the region were included. Some estimations couldn´t be calculated due to cell size. Causality cannot be assumed., Conclusion: Clinicians should in the first sessions address attitudinal factors that may lead to premature termination. Public policies need to consider distribution of services to increase convenience. A more rational use of resources would be to offer brief therapies to individuals most likely to drop out of treatment prematurely., (Copyright © 2022. Published by Elsevier B.V.)
- Published
- 2022
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