Media release

21 June 2004

NZ survey will check overseas mental health trends

International research showing that up to half of all people with serious mental disorders in the United States and several European countries are not receiving treatment is also being conducted in New Zealand.

The findings from the first of a series of World Health Organisation World Mental Health Surveys are published in the current issue of The Journal of the American Medical Association. They show the high prevalence and burden of mental disorders globally which, despite available treatments, remain largely untreated.

The first mental health survey report includes data from 14 countries (six less developed, eight developed) on the prevalence, severity, and treatment of mental disorders from more than 60 000 face-to-face interviews with adult individuals representing the general population.

Professor Mark Oakley Browne, the Principal Investigator for the New Zealand Mental Health Epidemiology Study (MHES), Te Rau Hinengaro says the New Zealand survey is contributing to the international surveys coordinated by the World Health Organization (WHO). He says the New Zealand national mental health community survey is currently under way.

The New Zealand survey uses the questionnaire and survey methodology developed for the WHO World Mental Health Surveys, with some local adaptations.

The survey is sponsored by the New Zealand Ministry of Health, is managed by the Health Research Council of New Zealand and has received approval from all the regional ethics committees.

The field work is being undertaken by the National Research Bureau, the survey firm which recently completed the national health survey for the Ministry of Health.

A team of researchers from the University of Auckland, University of Otago and Massey University will be responsible for the data analysis and preparation of reports. The survey will provide data about the prevalence of mental disorders, the disability associated with health problems, patterns of health service use and whether persons' mental health needs are being met.

As well as providing national and regional data, the survey will provide more detailed data for the Maori and Pacific communities than has previously been available.

As a collaborating nation in the WHO World Mental Health Surveys, data from the New Zealand survey may also be used for cross-national comparisons, Professor Browne says.

Ministry of Health Deputy Director-General Mental Health Dr Janice Wilson says having data from a New Zealand survey which is comparable with international information will be valuable for benchmarking levels of mental health in New Zealand and will contribute to planning for delivery of mental health services.

Background

The World Mental Health surveys were conducted from over three years (2002-2003) in the Americas (Colombia, Mexico, United States), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), the Middle East and Africa (Lebanon, Nigeria), and Asia (Japan, separate surveys in Beijing and Shanghai in China).

All the surveys used a structured diagnostic interview to assess disorders and treatment. Disorders considered included anxiety disorders, mood disorders, disorders that share a feature of problems with impulse control, and substance abuse disorders.

The researchers found that the prevalence of having any mental disorder in the prior year varied widely from less than 5% in Shanghai to 26% in the United States.

Between a 33% (Colombia) and 80% (Nigeria) of 12-month cases were mild.

Serious disorders were associated with substantial role disability [inability to carry out usual activities]. Although disorder severity was correlated with probability of treatment in almost all countries, 35% to 50% of serious cases in developed countries and 76% to 85% in less-developed countries received no treatment in the 12 months before the interview.

The study's authors say that the fact that many people with subthreshold disorders are treated while many with serious disorders are not shows that unmet need for treatment among serious cases suggests that limited treatment resources and poor prioritisation of treatment resources are involved.

The JAMA authors, Drs Ronald C. Kessler and T. Bedirhan Ustün wrote the report on behalf of 28 country network concluded.
(JAMA. 2004;291:2581-2590). Available at http://www.jama.ama-assn.org/cgi/reprint/291/21/2581