The usefulness of therapy as reported by patients was an essential indication of quality in patient-centered care. For a study, researchers sought to determine its routes and predictors in those who had ever been treated for severe depression, generalized anxiety disorder, social phobia, specific phobia, post-traumatic stress disorder, bipolar disorder, or alcohol use disorder.
The data originated from 30 community epidemiology surveys conducted as part of the World Health Organization’s World Mental Health (WMH) Surveys, – 17 in high-income countries (HICs) and 13 in low- and middle-income countries (LMICs). Respondents were asked if therapy for each disease was ever effective and, if so, how many experts they had to see before obtaining helpful treatment.
Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) said the first professional they saw benefited them. Following a first ineffective therapy, persisting with a second professional increased the cumulative likelihood of obtaining beneficial treatment to 51.2%. If patients continued to see up to eight providers, the cumulative likelihood increased to 90.6%. However, only an estimated 22.8% of patients would have persevered in seeing as many doctors despite getting therapies they deemed ineffective on several occasions. Although the proportion of people with problems who sought treatment was greater in HICs and they were more persistent than in LMICs, there was no difference in proportionate helpfulness among treated cases.
A diverse set of determinants of perceived treatment usefulness was discovered, some of which were similar across diagnostic categories and others that were particular to individual illnesses. The findings provided novel information about patient evaluations of treatment across diagnoses and countries with varying income levels, and they suggest that fostering persistence in professional help-seeking should be a critical issue in improving the quality of care for mental disorders if earlier treatments are ineffective.