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AJPH First Look, published online ahead of print Jul 31, 2007
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September 2007, Vol 97, No. 9 | American Journal of Public Health 1638-1643
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2006.090985

RESEARCH AND PRACTICE

Delay of First Treatment of Mental and Substance Use Disorders in Mexico

Guilherme Borges, ScD, Philip S. Wang, MD, PhD, Maria Elena Medina-Mora, PhD, Carmen Lara, MD and Wai Tat Chiu, MA

Guilherme Borges is with the National Institute of Psychiatry and the Metropolitan Autonomous University, Mexico City, Mexico. Maria Elena Medina-Mora is with the National Institute of Psychiatry, Mexico City. Carmen Lara is with the National Institute of Psychiatry and the Puebla Autonomous University, Puebla, Mexico. Philip S. Wang and Wai Tat Chiu are with the Department of Health Care Policy, Harvard Medical School, Boston, Mass.

Correspondence: Requests for reprint should be sent to Guilherme Borges, Instituto Nacional de Psiquiatria, Calzada Mexico Xochimilco No 101- Col. San Lorenzo Huipulco, Mexico D.F. C.P.14370, Mexico (e-mail: guibor{at}imp.edu.mx).

Objectives. We studied failure and delay in making initial treatment contact after the first onset of a mental or substance use disorder in Mexico as a first step to understanding barriers to providing effective treatment in Mexico.

Methods. Data were from the Mexican National Comorbidity Survey (2001–2002), a representative, face-to-face household survey of urban residents aged 18 to 65 years. The age of onset for disorders was compared with the age of first professional treatment contact for each lifetime disorder (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).

Results. Many people with lifetime disorders eventually made treatment contact, although the proportions varied for mood (69.9%), anxiety (53.2%), and substance use (22.1%) disorders. Delays were long: 10 years for substance use disorders, 14 years for mood disorders, and 30 years for anxiety disorders. Failure and delay in making initial treatment contact were associated with earlier ages of disorder onset and being in older cohorts.

Conclusions. Failure to make prompt initial treatment contact is an important reason explaining why there are unmet needs for mental health care in Mexico. Meeting these needs will likely require expansion and optimal allocation of resources as well as other interventions.






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