The quality of care for depression and anxiety

Young AS, Klap R, Sherbourne CD, Wells KB. The quality of care for depression and anxiety. Paper presented at: American Psychiatric Association Annual Meeting; 2000 May 1; Chicago, IL.

Objective: Little is known about the quality of care for psychiatric disorders nationally. We estimate the rate of appropriate psychotropic medication or counseling among the U.S. population with depressive and anxiety disorders, and examine factors affecting use of appropriate care. Method: 1641 adults with a probable 12-month depressive or anxiety disorder were drawn from a national sample. Data is from a telephone survey during 1997-1998. Results: During the past year, 82% of adults with probable depressive or anxiety disorders saw a healthcare provider, and 31% used some appropriate treatment. Most visited medical providers only, and these people had significantly lower rates of appropriate treatment than people visiting specialists. Rates of appropriate treatment were lower for men, African Americans, the less educated, and adults under 30 or over 59 years old. Insurance status and income did not have unique effects on use of appropriate care. Conclusions: The majority of adults with a probable depressive or anxiety disorder receive no appropriate care. While this holds across diverse groups, rates of appropriate care are lower in certain demographic subgroups. Public education and practice-level quality improvement efforts are broadly needed, and should also target these subgroups.