GENERAL: Why the provision of mental health treatment needs to change
From Community Psychology: In Pursuit of Liberation and Well-being, pp. 10 - 11:
"The Ontario Health Supplement conducted in 1991 found that in a representative sample of adults in Ontario (close to 10,000 respondents) the one-year prevalence rate for any mental disorder was 48% (Offord et al., 1994). In the Ontario Child Health study of a representative sample of children and young people (3,000 children) in Ontario, Offord et al. (1987) found a one-year prevalence rate of 18% for any disorder.
What is most disturbing about these findings is that the majority of adults and children with mental disorders were not receiving any mental health intervention for their problems (Offord et al., 1987; Offord et al., 1994). Based on his report on human resources in mental health, George Albee (1959) concluded that there were not, and never could be, enough trained mental health professionals to provide treatment services to everyone with a mental health problem. Even if therapy were 100% effective, mental health problems could not be eliminated, because the need for services far outstips their supply. As Albee (1996a) has reminded us, 'no mass disease (disorder) in human history has ever been eliminated or significantly controlled by attempts at treating the affected individual, nor by training large numbers of individual treatment personnel' (pp. 4-5).
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Schofield (1964) argued that psychotherapy tends to be geared to clients who are young, attractive, verbal, intelligent and successful. To this list we can add that psychotherapy clients are those who have health insurance or can afford this treatment. In their famous study of social class and mental illness, Hollingshead and Redlich (1958) found a two-tiered system of treatment, one for the affluent and one for the poor. Affluent people with less serious mental health problems tended to receive psychotherapy, while poor people with more serious mental health problems tended to be 'treated' in mental hospitals with drug therapy and custodial care.
As Offird et al. (1994) reported, nearly half (42%) of those respondents who do not have a diagnosable mental disorder receive some form of mental health intervention. Beiser, Gill and Edwards (1993) reviewed factors that influence people's utilization of mental health services and they argued that treatment approaches typically reflect Europ-North American values, which may contradict the beliefs of people from different cultures. Language is another barrier for some cultural and ethnic groups to receiving mental health intervention. As a result, many ethnic minority consumers either do not access services or they drop out of programs after their initial contacts."