A survey coordinated by the World Health Organisation shows that New Zealand access to services for mental health is better than in most countries, but is still not adequate. The survey covered 17 countries across all income levels and involved face-to-face interviews with 84,850 adults.

The results of the survey were published in the prestigious British medical journal 'The Lancet'. The 'Global Burden of Disease and Risk Factors' reports that depression is the leading cause of disability amongst adults over 15. The survey shows that many mental health care needs are going unmet, particularly in less developed countries.

"There's a need in developing countries for improved access to mental health care, but the situation in high income countries is also not good," says Dr Elisabeth Wells who was involved in the team that carried out the New Zealand part of the survey. "We're among the few top countries, but there is still much to be done, with over 40 per cent of severe cases not having any treatment contact."

Use of mental health services by those with mental disorders varied markedly. New Zealand has the second highest use rate at 14 per cent after the United States at 18 per cent. Nigeria has the lowest use rate at 2 per cent. Those with severe disorders were more likely to use mental health services; 57 per cent of those people in this category in NZ contacted services in the last year.

Most people use primary health care services, rather than specialists such as psychiatrists, psychologists or mental health teams, or counsellors and alternative medicine providers. In New Zealand 86 per cent of people who contacted services also had at least one follow-up visit, and 93 per cent of those with severe disorder had follow-up.

Other key points to come out of the WHO survey are:

• Middle-aged people are more likely to receive services than the young or old
• People with more education are more likely to access services
• Married people are less likely to use mental health services than unmarried

Overall the survey revealed very high levels of unfulfilled need for more mental health treatment worldwide, especially in less developed countries. However in developed countries about 50 per cent of all severe cases received no services. Among those cases receiving care, even fewer were effectively treated with minimally adequate care.