Mental illness rate steady, treatment rises, study says

BOSTON - Americans grappling with mental illness are more likely to be treated for it now than they were 10 years ago, according to a landmark government-backed survey.

The rate of mental illness has remained the same, but researchers believe that with more treatment inroads in the future, rates should eventually start to drop.

"I think things are going to move in a good direction, but we're sort of in the midst of it," said study leader Ronald Kessler of Harvard Medical School.

However, a more troubling possibility, some experts acknowledged, is that treatment too often fails to work -- and that's why the rate of illness has held steady.

The study, partly funded by the National Institute of Mental Health and several drug companies, was published today in the New England Journal of Medicine. The researchers surveyed a nationally representative sample of 5,388 people in the early 1990s and 4,319 from 2001 to 2003. Both groups spanned ages 18 to 54.

One-third of those with a verified disorder now undergo treatment -- up from a fifth a decade ago. The share of all people treated rose from 12 percent to 20 percent. The greatest treatment gains came in the primary care setting, where family doctors increasingly prescribe drugs for depression and other psychiatric ailments.

In a worrisome finding, blacks and Hispanics with a verified disorder were only half as likely to gain treatment as whites, according to findings combining both time periods.

However, some specialists took heart in the expansion of treatment in the general population over the decade.

"Probably the most positive message out of the paper is the amount of true increase in treatment that is documented here. I think that is the result of a decrease in the stigma," said psychiatrist Dr. Darrel Regier, an expert on the frequency of such diseases and research director for the American Psychiatric Association.

Experts also tied rising treatment to broader insurance coverage and more treatment programs, especially among corporations.

"The treatments done correctly ... can help people substantially," said Kessler. But he added that for mild illness "we don't have a clue as to what will be effective." In a separate commentary in the journal, Dr. Eva Schernhammer, another public health specialist at Harvard, appealed for more efforts to cut the high rate of suicide among doctors.

She published research last year showing that the suicide rate among male doctors is 40 percent higher than among men in general. The rate among female doctors is 130 percent higher than among all women.

One in 10,000 Americans commits suicide in a typical year, federal health agencies report. That's more than 30,000 victims, outstripping the homicide rate. Men in the general population kill themselves more often than women, yet female doctors are more prone than their male colleagues.

In an interview, Schernhammer said it appears that female doctors, who understand the action of poisons, appear to commit more successful suicides than women in general.

She said doctors need more mental health programs that strictly protect their privacy, since they "might be worried that if they openly discuss any mental health programs, then they have to fear for their license to practice."