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Briefing Paper

Updated April 2007

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What percentage of individuals with severe psychiatric disorders are receiving no treatment?

SUMMARY: Recent U.S. studies report that approximately half of all individuals with severe mental illnesses have received no treatment for their illnesses in the previous 12 months. These findings are consistent with other studies of medication compliance for individuals with schizophrenia and manic-depressive illness (bipolar disorder). In terms of numbers, this means that approximately 2 million individuals with schizophrenia and bipolar disorder are receiving no treatment for their illness at any given time.

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35 percent untreated

In the five-site Epidemiologic Catchment Area (ECA) survey carried out in 1980–1985, it was reported that 35 percent of individuals with schizophrenia and 35 percent of individuals with bipolar disorder had received no treatment in the previous 12 months.

Health care reform for Americans with severe mental illnesses: report of the National Advisory Mental Health Council. American Journal of Psychiatry 150:1447–1465, 1993.

50 percent untreated

In a follow-up study at the Baltimore site of the ECA study, one half of the individuals with schizophrenia who were living in the community were receiving no treatment. According to the authors, "all of the untreated schizophrenic subjects were in need of mental health care at the time of the survey."

Von Korff M et al. Prevalence of treated and untreated DSM-III schizophrenia. Journal of Nervous and Mental Disease 73:577–581, 1985.

42 percent untreated

In another follow-up of the ECA study data, it was established that 42 percent of individuals with severe mental illnesses (as defined by the NIMH Advisory Mental Health Council) were not being treated.

Narrow WE. Mental health service use by Americans with severe mental illnesses. Social Psychiatric Epidemiology 35:147–155, 2000.

54 percent untreated

Using data for the National Comorbidity Survey (NCS) carried out in 1990–1992, the authors reported that 54 percent of individuals with serious mental illness (broadly defined) had received no treatment in the previous 12 months.

Kessler RC et al. The prevalence and correlates of untreated serious mental illness. Health Services Research 36:987–1007, 2001.

46 percent untreated

By examining prescription refill records on 25,000 patients, it was found that 46 percent of individuals who had been taking antipsychotic medications were no longer taking the medications 9 months later. This study focused only on patients who were in the treatment system and did not include those who were homeless, incarcerated, etc.

Vanelli M et al. Refill patterns of atypical and conventional antipsychotic medications at a national retail pharmacy chain. Psychiatric Services 52:1248–1250, 2001.

It therefore appears that approximately one-half of individuals with schizophrenia and bipolar disorder are receiving no treatment at any given time. Since there are estimated to be approximately 4 million individuals affected with these diseases in the United States, that means that approximately 2 million individuals with schizophrenia and bipolar disorder are receiving no treatment.

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