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Clinical and Research News
Study Seeks Answers To Treatment Dropout
Psychiatric News
Volume 37 Number 12 page 28-28

Nineteen percent of Americans in treatment for various kinds of mental health problems drop out of treatment prematurely. Seventeen percent of Canadians in treatment do so as well.

These similar findings have emerged from a study conducted by Mark Edlund, M.D., Ph.D., of the Neuropsychiatric Institute at the University of California at Los Angeles, along with American and Canadian colleagues. The study is reported in the May American Journal of Psychiatry.

The 1,200 subjects that Edlund and his coworkers included in their study were either from the United States or Ontario, Canada, and had responded to community epidemiological surveys conducted in the early 1990s. The surveys were the U.S. National Comorbidity Survey and the Mental Health Supplement to the Ontario Health Survey.

These 1,200 persons indicated on the surveys that they had been under treatment for major depression, mania, dysthymia, social phobia, simple phobia, agoraphobia, generalized anxiety disorder, manic disorder, alcohol abuse or dependence, or drug abuse or dependence but had dropped out of treatment before they had experienced symptom improvement.

Edlund and his team then compared the number of American treatment dropouts with the number of Canadian treatment dropouts and found that they were similar: 19 percent in the United States and 17 percent in Canada. The researchers also used survey responses from the 1,200 subjects to get some idea of why they had terminated treatment before they had been fully helped.

One major factor, the researchers discovered, applied to both groups of subjects: being young (15 to 24 years old); another factor applied to the U.S. subjects: not having mental health insurance. (The Canadian subjects had access to unlimited free mental health treatment visits.)

Other factors included viewing mental health treatment as relatively ineffective, being embarrassed about seeing a mental health professional, and being offered either medications or psychotherapy instead of both. Income, education, gender, and race did not seem to explain why subjects dropped out of treatment, nor did type of mental problem.

The study was funded by the National Institute of Mental Health, the W.T. Grant Foundation, and the Ontario Mental Health Foundation.

The study, "Dropping Out of Mental Health Treatment: Patterns and Predictors Among Epidemiological Survey Respondents in the United States and Ontario," is posted on the Web at http://ajp.psychiatryonline.org/cgi/content/full/159/5/845?.

Am J Psychiatry2002159845

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