Mental health service use among South Africans for mood, anxiety and substance use disorders
Design: A nationally representative survey of 4351 adults. Twelve-month DSM-IV diagnoses, severity, and service utilisation were determined using the WHO Composite International Diagnostic Interview (CIDI). 12-Month treatment was categorized by sector and province. South Africans in households and hostel quarters were interviewed between 2002-2004 in all 9 provinces.
Outcome measures: 4317 respondents 18 years and older were analysed. Bivariate logistic regression models predicted (i) 12-month treatment use of service sectors by gender, and (ii) 12-month treatment use by race by gender.
Results: 25.2% of respondents with a mental disorder had sought treatment within the previous 12 months; 5.7% had used any formal mental health service. Mental health service use was highest for adults with mood and anxiety disorders and among those with a mental disorder varied by province, from 11.4% (Western Cape) to 2.2% (Mpumalanga). More women received treatment largely attributable to higher rates of treatment in women with mood disorders. Age, income, education and marital status were not significantly associated with mental health service use. Race was associated with the treatment sector accessed in those with a mental disorder.
Conclusions: There is a substantial burden of untreated mental disorders in the South African population, across all provinces and even in those with substantial impairment. Greater allocation of resources to mental health services and more community awareness initiatives are needed to address the unmet need.
Soraya Seedat, University of Stellenbosch
David R Williams, Harvard University
Kathleen McGaffigan, Harvard University
Allen Herman, MEDUNSA
Hashim Moomal, University of Witwatersrand
Stacey L Williams, University of Michigan
Pamela B Jackson, Indiana University
Landon Meyer, University of Cape Town
Dan J Stein, University of Cape Town
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Date published: 2009-05-11
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