There is debate about the correspondence between
prevalence estimates of mental disorders from large
epidemiologic surveys and the measurement of need for
psychiatric services in the community. There is also
a growing consensus that a significant proportion of
cases remains untreated in the community. This
dissertation addresses the problem of need and use of
mental health services for depression, alcohol
dependence, social phobia, panic disorder, and
agoraphobia, from five perspectives. First, it
provides an estimate of the need for mental health
services in the community, independent of diagnosis,
and compare it to estimates based on prevalence data.
Second, it provides data demonstrating the contrast
between those who use and those who do not use mental
health services. Third, it assesses how insight
affects the likelihood of using services for mental
disorders. Fourth, it measures the sensitivity and
specificity of the Global Assessment of Function
(GAF) in identifying need for services. Fifth, it
investigates two possible sources of bias in samples
of treated individuals: the role of psychiatric
comorbidity and that of family history of
mental disorders in use of services.
Mental Health Needs in the United States:Epidemiological Estimates: Psychiatrists' Ascertained Need for Mental HealthServices in a Community Sample