Dear HIFA colleagues,
Below are the citation and summary of a new paper in The Lancet Psychiatry, and four comments from me.
CITATION: Service coverage for major depressive disorder: estimated rates of minimally adequate treatment for 204 countries and territories in 2021
Santomauro, Damian F et al.
The Lancet Psychiatry, Volume 11, Issue 12, 1012 - 1021
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00317-1/fulltext
SUMMARY
Background: Access to effective treatment for major depressive disorder remains limited and difficult to track across place and time. We analysed the available data on minimally adequate treatment (MAT) for major depressive disorder globally...
Methods: MAT was defined as pharmacotherapy (1 month of medication, plus four visits to a medical doctor) or psychotherapy (eight visits with any professional)...
Findings: ... The proportion of people with major depressive disorder receiving MAT globally in 2021 was 9·1% (95% uncertainty interval 7·2–11·6), with 10·2% (8·2–13·1) of females and 7·2% (5·7–9·3) of males with major depressive disorder receiving MAT...
Interpretation: Despite many gaps in the available data, estimates show that, globally, most individuals with major depressive disorder do not receive MAT... Urgent attention should be given to the scale-up of effective intervention strategies, especially in low-income and middle-income countries, as well as further research into better quality treatment options for major depressive disorder...
COMMENTS (NPW):
1. The definition of MAT does not include quality, so the number of people receiving adequate quality care will presumably be even lower than the figures suggest.
2. The appaling coverage of minimally adequate treatment should be a wake-up call for governments worldwide.
3. 'Scale-up of effective intervention strategies' implies task sharing with community health workers as promoted by HIFA member Vikram Patel and others, but the above paper does not explore this.
4. Meeting the information needs of the general public, caregivers, health workers and policymakers is vital. HIFA stands ready to host a new HIFA Project on this topic in 2025. Contact us if you are interested to discuss options: neil@hifa.org
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
