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Most people with depression receive inadequate treatment or no care at all

November 30, 2016

The vast majority of people with depression across the world are not receiving even minimally adequate treatment for their condition, according to a new study of more than 50,000 people in 21 countries by King's College London, Harvard Medical School and the World Health Organization (WHO).

The research, published today in the British Journal of Psychiatry, reports that of 4,331 people with depression across all 21 countries, treatment rates vary widely. In high income countries only one in five people with depression receive adequate treatment. The situation in the poorest countries of the world is far worse, where one in 27 people with depression receive adequate treatment.

Globally, an estimated 350 million people of all ages suffer from depression, and the condition is the leading cause of disability worldwide. There is an increasing awareness that depression can be reliably diagnosed and treated in primary care settings using psychological therapy or medication, yet these scientifically proven and effective treatments are not being delivered on a wide scale.

The researchers analysed data from the WHO World Mental Health Surveys, a series of 23 community surveys in 21 countries. These included 10 low or middle income countries (Brazil, Bulgaria, Colombia, Iraq, Lebanon, Mexico, Nigeria, People's Republic of China (PRC), Peru and Romania) and 11 high income countries (Argentina, Belgium, France, Germany, Israel, Italy, Japan, Netherlands, Portugal, Spain and the USA).

The researchers defined minimally adequate treatment as receiving either pharmacotherapy (at least one month of medication plus four or more visits to a doctor) or psychotherapy (at least eight visits with any professional including religious or spiritual advisor, social worker or counsellor).

Professor Graham Thornicroft from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, who led the study, said: 'We call on national and international organisations to make adequate resources available for scaling up the provision of mental health services so that no one with depression is left behind. Our results indicate that much treatment currently offered to people with depression falls far short of the criteria for evidence-based and effective treatment.

'Intriguingly, about half of all people with depression did not think they had a problem that needed treatment and this proportion fell to only a third in the poorest countries. This strongly suggests that we also need to support people with depression and their family members to recognise that they have a treatable condition and should seek treatment and care.'

Professor Thornicroft added: 'Providing treatment at the scale required to treat all people with depression is crucial, not only for decreasing disability and death by suicide, but also from a moral and human rights perspective, and to help people to be fully productive members of society.'

This study was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative.
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Notes to editors

For further media information please contact Jack Stonebridge, Senior Press Officer, Institute of Psychiatry, Psychology & Neuroscience, King's College London jack.stonebridge@kcl.ac.uk/ 020 7848 5377 or 07718697176.

About King's College London - http://www.kcl.ac.uk

King's College London is one of the top 25 universities in the world (2016/17 QS World University Rankings) and among the oldest in England. King's has more than 26,500 students (of whom nearly 10,400 are graduate students) from some 150 countries worldwide, and nearly 6,900 staff. The university is in the second phase of a £1 billion redevelopment programme which is transforming its estate.

King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King's was ranked 6th nationally in the 'power' ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King's was deemed 'world-leading' or 'internationally excellent' (3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £600 million.

King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.

King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: http://www.kingshealthpartners.org.

King's College London

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