Minding the treatment gap: results of the Singapore Mental Health Study
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ORIGINAL PAPER
Minding the treatment gap: results of the Singapore Mental Health Study Mythily Subramaniam1,2 · Edimansyah Abdin1 · Janhavi Ajit Vaingankar1 · Saleha Shafie1 · Hong Choon Chua3 · Weng Mooi Tan4 · Kelvin Bryan Tan5 · Swapna Verma6 · Derrick Heng7 · Siow Ann Chong1 Received: 24 December 2018 / Accepted: 10 July 2019 © The Author(s) 2019
Abstract Purpose To establish the 12-month treatment gap and its associated factors among adults with mental disorders in the Singapore resident population using data from the second Singapore Mental Health Study and to examine the changes since the last mental health survey conducted in 2010. Methods 6126 respondents were administered selected modules of the Composite International Diagnostic Interview, to assess major depressive disorder (MDD), dysthymia, bipolar disorder, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD) and alcohol use disorder (AUD) (which included alcohol abuse and dependence). Past year treatment gap was defined as the absolute difference between the prevalence of a particular mental disorder in the past 12 months preceding the interview and those who had received treatment for that disorder. Results The prevalence of overall 12-month treatment gap in this population was high (78.6%). A multiple logistic regression analysis revealed significantly higher odds of treatment gap among those diagnosed with OCD (compared to those with MDD) and in those with a comorbid chronic physical disorder; while those who had primary education and below and those who were unemployed were less likely to have a treatment gap as compared to those with post-secondary education and those employed, respectively. Conclusions The high treatment gap in the population is concerning and highlights the need to promote help-seeking and uptake of treatment. Given the unique demographic characteristics, i.e., those with higher education and employed were more likely not to seek treatment, targeted interventions in the educational and workplace settings should be implemented. Keywords Major depressive disorder · Generalized anxiety disorder · Obsessive compulsive disorder · Alcohol use disorder · Prevalence
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00127-019-01748-0) contains supplementary material, which is available to authorized users. * Mythily Subramaniam [email protected] 1
Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore
2
Lee Kong Chian School of Medicine, Singapore, Singapore
3
CEO Office, Institute of Mental Health, Singapore, Singapore
4
Community Mental Health Division, Agency for Integrated Care (AIC), Singapore, Singapore
The World Health Organization’s global health report has estimated that 4.4% of the world’s population suffers from depression and 3.6% from anxiety disorders which means 5
Policy, Research and Evaluation Division, Ministry of Health, Singapore, Singapore
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