title: Drop out from out-patient mental healthcare in the World Health Organization's World Mental Health Survey initiative.
abstract: BACKGROUND
  Previous community surveys of the drop out from mental health treatment have been carried out only in the USA and Canada.
  
  
  OBJECTIVE
  To explore mental health treatment drop out in the World Health Organization World Mental Health Surveys.
  
  
  METHODS
  Representative face-to-face household surveys were conducted among adults in 24 countries. People who reported mental health treatment in the 12 months before interview (n = 8482) were asked about drop out, defined as stopping treatment before the provider wanted.
  
  
  RESULTS
  Overall, drop out was 31.7%: 26.3% in high-income countries, 45.1% in upper-middle-income countries, and 37.6% in low/lower-middle-income countries. Drop out from psychiatrists was 21.3% overall and similar across country income groups (high 20.3%, upper-middle 23.6%, low/lower-middle 23.8%) but the pattern of drop out across other sectors differed by country income group. Drop out was more likely early in treatment, particularly after the second visit.
  
  
  CONCLUSIONS
  Drop out needs to be reduced to ensure effective treatment.
authors.affiliation: Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand. elisabeth.wells@otago.ac.nz
authors.forename: J Elisabeth
authors.initials: JE
authors.lastname: Wells
authors.forename: Mark Oakley
authors.initials: MO
authors.lastname: Browne
authors.forename: Sergio
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authors.lastname: Aguilar-Gaxiola
authors.forename: Ali
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authors.lastname: Al-Hamzawi
authors.forename: Jordi
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authors.lastname: Alonso
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Angermeyer
authors.forename: Colleen
authors.initials: C
authors.lastname: Bouzan
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.forename: Brendan
authors.initials: B
authors.lastname: Bunting
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.forename: Giovanni
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authors.lastname: de Girolamo
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.forename: Akira
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authors.lastname: Fukao
authors.forename: Oye
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authors.lastname: Gureje
authors.forename: Hristo Ruskov
authors.initials: HR
authors.lastname: Hinkov
authors.forename: Chiyi
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authors.lastname: Hu
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.forename: Elie G
authors.initials: EG
authors.lastname: Karam
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kostyuchenko
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
authors.forename: Daphna
authors.initials: D
authors.lastname: Levinson
authors.forename: Zhaorui
authors.initials: Z
authors.lastname: Liu
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Medina-Mora
authors.forename: S Haque
authors.initials: SH
authors.lastname: Nizamie
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015897:Comorbidity; D003710:Demography; D014943:Global Health / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007182:Income; D007406:Interview, Psychological; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014944:World Health Organization; D055815:Young Adult