Vast majority of people with depression do not receive treatment, global review finds

Depression has become one of the leading causes of disability worldwide, with no signs of slowing down. By 2030, the World Health Organization predicts that disease could be the biggest contributor to the global burden of disease.

Although we now have some effective treatments for depression, including medications and psychological interventions, medical care remains deplorable in all areas.

In high-income countries, a review of the available literature found that only 23% of patients with depression receive ‘minimally adequate’ treatment. In low- and middle-income countries, a measly 3% receive minimal care.

The analysis is based on 149 studies from 84 countries between 2000 and 2021, and while there are some data gaps from regions like South Asia and sub-Saharan Africa, the results paint a grim overall picture.

“Treatment coverage for major depressive disorder continues to be low globally, with many people not receiving a level of care consistent with practice guideline recommendations,” says epidemiologist Alize Ferrari of the University of Queensland, Australia.

“This highlights the need to reconsider the availability of appropriate care and treatment facilitators as we respond to the heavy burden imposed by this disorder.”

Previous reviews have found that depression treatment gaps can range from 45% in Europe to 67% in the African region and 70% in the Eastern Mediterranean region.

As the current review found, the quality of these treatments can also vary greatly depending on where in the world a person lives.

Just as other research has shown before, people around the world seem to be more likely to receive treatment for depression if they are female and as they get older. Younger and male patients, on the other hand, are less likely to seek care for problems related to emotions or moods.

While mental health services have improved dramatically in some countries and stigma around the disorder is gradually being reduced, most of the countries featured in the review still lack basic mental health policy, legislation and resources. mental health to guide patients and physicians.

“Global health financing has always been prioritized for malaria, HIV/AIDS and tuberculosis – which are among the leading causes of disability and death in many low- and middle-income countries,” the authors write.

“However, funding for mental health is still far from sufficient.”

In 2019, global funding for “non-communicable” diseases like depression and other mental health disorders accounted for less than 2% of all development assistance for health that year.

Clearly, we need to scale up effective treatments for depression and anxiety disorders globally. If we can do this, studies show the world could save an additional 43 million years of healthy life between 2016 and 2030, not to mention billions of dollars.

If we don’t, much more will be lost.

Chronic feelings of hopelessness, grief, or low self-esteem, as well as fatigue, sleep problems, or changes in appetite can have physical and emotional consequences, leading to changes in heart rate, increased inflammation, metabolic changes and elevated levels. of stress hormones.

Although not all forms of depression are treatable, it is one of the most treatable mental health conditions, with around 80-90% of people improving after seeking medication, psychological help or electroconvulsive therapy.

Even before the pandemic hit in 2020, global cases of depression were expected to rise, and now a surge seems more likely than ever. Depression rates in the United States actually tripled when the pandemic first hit, and they haven’t gone down since.

In an article published in 2021, the researchers warned that we were very ill-prepared for the future.

“This pandemic has created an increased urgency to strengthen mental health systems in most countries,” the document says.

“Mitigation strategies could incorporate ways to promote mental well-being and target the determinants of poor mental health and interventions to treat people with a mental disorder. Take no action to address to the burden of major depressive disorder and anxiety disorders should not be an option.”

The study was published in OLP Medicine.

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