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AJPH First Look, published online ahead of print May 2, 2006
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June 2006, Vol 96, No. 6 | American Journal of Public Health 954
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2006.085548

LETTER

SIGNIFICANT PSYCHOLOGICAL DISTRESS AND CONTACTS WITH MENTAL HEALTH PROFESSIONALS

Katharine H. McVeigh, PhD, MPH and Robin A. Wunsch-Hitzig, PhD

The authors are with the New York City Department of Health and Mental Hygiene, New York, NY.

Correspondence: Requests for reprints should be sent to Katharine H. McVeigh, PhD, MPH, Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, 125 Worth St, Room 315, CN-6, New York, NY 10013 (e-mail: tmcveigh{at}health.nyc.gov).

Mojtabai’s article, "Trends in Contacts With Mental Health Professionals and Cost Barriers to Mental Health Care Among Adults With Significant Psychological Distress in the United States: 1997–2002,"1 is informative and provides policymakers with critical information regarding the national burden of significant psychological distress, as well as trends in potential unmet need for treatment. However, we recommend additional analyses that would make the findings more useful for mental health service planning.

First, urban–rural differences in both the prevalence of significant psychological distress and the treatment contact rate should be examined. Previous studies have shown that urban areas have a higher prevalence of psychiatric disorders than rural areas.2–5 Local plans based on national estimates may grossly underestimate true need in urban areas.

Second, access to mental health treatment should be examined by the severity of significant psychological distress. Few would disagree that most, if not all, individuals with K6 scores between 19 and 24 require mental health treatment, but it is unlikely that treatment is necessary or even desirable for all individuals with K6 scores between 13 and 18. Mental health planners would be better informed by the treatment contact rate among the most severe cases, which may be considerably higher than the rate of 35.5% reported by Mojtabai.

References

1. Mojtabai R. Trends in contacts with mental health professionals and cost barriers to mental health care among adults with significant psychological distress in the United States: 1997–2002. Am J Public Health. 2005;95:2009–2014.[Abstract/Free Full Text]

2. Wang JL. Rural–urban differences in the prevalence of major depression and associated impairment. Soc Psychiatry Psychiatr Epidemiol. 2004;39:19–25.[CrossRef][ISI][Medline]

3. van Os J, Hanssen M, Bijl RV, Vollebergh W. Prevalence of psychotic disorder and community level of psychotic symptoms: an urban–rural comparison. Arch Gen Psychiatry. 2001;58:663–668.[Abstract/Free Full Text]

4. Paykel ES, Abbott R, Jenkins R, Brugha TS, Meltzer H. Urban–rural mental health differences in Great Britain: findings from the national morbidity survey. Psychol Med. 2000;30:269–280.[CrossRef][ISI][Medline]

5. Blazer D, George LK, Landerman R, et al. Psychiatric disorders. A rural/urban comparison. Arch Gen Psychiatry. 1985;42:651–656.[Abstract]





This Article
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96/6/954    most recent
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