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Use of clinical and service indicators to decrease the treatment gap for mental disorders: a global perspective

people with mental illness are not treated (Thornicroft, 2007), the impact of any serious undertaking in the area of global mental health has to be judged against the benchmark of whether it leads to more people being treated. Treatment gap for mental disorders can be defined as the proportion of individuals who require but do not receive treatment. Some recent studies have demonstrated that treatment gap for mental disorders is surprising high. A review of international literature (Kohn et al., 2004) revealed that one-third of all individuals with Schizophrenia and other non-affective psychoses do not receive any treatment. Figures for depression, dysthymia, bipolar disorder, panic, obsessive compulsive and anxiety disorders are all around 50%. The World Mental Health Survey data show that 35 to 50% of serious cases in developed countries and 76 to 85% in developing countries received no treatment in the previous year (WHO World Mental Health Consortium, 2004). This commentary examines a few selected issues around the role and limitations of clinical and service indicators in decreasing the treatment gap in a global perspective. It also introduces WHO’s indicator scheme for assessing mental health systems.