While much brain and behavior research focuses on discovering causes and finding new treatments for major psychiatric illness, another branch of research concerns the less often discussed but very real problem of how to get more patients to seek available treatments.

Since the 1980s, when face-to-face survey techniques were perfected, researchers have repeatedly confirmed that a remarkably small fraction of those who suffer from various mental illnesses actually seek treatment. Depending on how one defines the act of seeking help, estimates over the years have ranged from about 25 percent to 50 percent. The figures vary greatly according to illness and severity of symptoms.

A team that included three past NARSAD grantees published a paper December 1st in the journal Psychiatric Services that closely examines the circumstances under which people diagnosed with attention deficit-hyperactivity disorder (ADHD) first reach out for treatment. “Treatment-seeking is a critical first step,” the team writes, “and remains insufficiently understood.” Lead author Carlos Blanco, M.D., Ph.D., along with co-authors who included Mark Olfson, M.D., Ph.D., and Frances Levin, M.D., all previously funded by the Foundation,* aimed to estimate the probability over a lifetime that an affected person would seek treatment. They also sought to predict factors that may have influenced their decision. This method helps identify ways to get those who don’t seek treatment to reach out for help.

The team’s data, drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (concluded in 2005), indicated that there was a 55 percent lifetime probability that someone with ADHD would seek treatment––whether from a psychiatrist, social worker, or general medical doctor. Though males and females demonstrated similar lifetime probabilities of seeking treatment, their response patterns differed according to sex. Among males with ADHD, a delay in seeking help was more likely among African-Americans, people with less than 12 years of schooling, people with paranoid personality disorder, and those older than age 30 at the time of their interview for the survey. On the other hand, some men were less likely to delay. This group included people with alcohol dependence, depression, or borderline personality disorder.

Among women with ADHD, the only factor that predicted a delay in seeking help was age (over 44 years). Women with bipolar illness were more likely to seek help for their ADHD. Among both men and women with early-onset ADHD, men were more likely to delay seeking treatment.

“A large proportion of persons with ADHD do not seek treatment,” the researchers noted. The fact that more predictors of delay were found in men suggested to the team that there are more identifiable barriers to seeking treatment in males and therefore males might be more responsive to efforts specifically designed to ease their way into treatment. Future research will attempt to develop methods to do this, they said.

* Carlos Blanco, M.D., Ph.D., Young Investigator, 1999, 2001; Frances R. Levin, M.D., Independent Investigator, 2000; Mark Olfson, M.D., M.P.H., Distinguished Investigator, 2005