Bulletin of the World Health Organization

Service availability and utilization and treatment gap for schizophrenic disorders: a survey in 50 low- and middle-income countries

Antonio Lora, Robert Kohn, Itzhak Levav, Ryan McBain, Jodi Morris & Shekhar Saxena

Volume 90, Number 1, January 2012, 47-54B

Table 1. Spearman’s correlation coefficients for associations between treatment gap, treated prevalence and facility utilization rates and preselected predictors obtained from the World Health Organization’s Assessment Instrument for Mental Health Systems

Predictor Treatment gapa Treated prevalenceb Facility utilization ratec
Outpatient Inpatient
Mental hospital General hospital psychiatric unit
Prevalence of schizophrenic disorders −0.41*** 0.52**** 0.50**** 0.57**** 0.14
Population 0.25* −0.25* −0.23 −0.17 −0.13
Gross national incomed (by Atlas method) −0.58**** 0.59**** 0.54**** 0.57**** 0.14
Expenditure on mental hospitals as fraction of health expenditure −0.01 −0.21 −0.05 −0.18 −0.25
Affordability of antipsychotic medications −0.09 0.10 0.02 0.08 0.22
Integration of mental hospitals with outpatient facilities −0.07 −0.03 −0.04 −0.18 0.42***
Provision for follow-up care in community 0.12 −0.11 −0.12 −0.06 −0.04
Percentage of outpatient facilities with mental health mobile teams 0.001 −0.001 −0.01 −0.03 0.03
Bedse in community psychiatric inpatient units −0.25* 0.24* −0.01 −0.05 0.96****
Bedse in community residential facilities 0.11 −0.10 −0.16 0.09 −0.05
Bedse in mental hospitals −0.38*** 0.36*** 0.11 0.10 0.95****
Percentage change in beds in mental hospitals, past 5 years −0.17 0.15 0.11 −0.08 0.38***
Psychiatric beds (per capita) located in or near largest city −0.02 −0.02 −0.10 −0.15 0.36**
Psychiatristse −0.65**** 0.72**** 0.70**** 0.63**** 0.10
Nursese in mental health facilities −0.78**** 0.81**** 0.72**** 0.82**** 0.15

*P < 0.1, **P < 0.05, ***P < 0.01, ****P < 0.001.

a Represented by the proportion of individuals affected by schizophrenic disorders who fail to receive treatment.

b Calculated as the number of people per 100 000 who were treated annually for schizophrenic disorders in all mental health facilities.

c Calculated as the number of people treated annually for schizophrenic disorders in each type of mental health facility divided by the total number of patients with schizophrenic disorders treated annually in all mental health facilities.

d For gross national income, data were available for only 48 countries. In all other instances, data were available for all 50 countries.

e Per 100 000 population.

Note: Variables that yielded statistically significant correlations (P < 0.05) were included in multivariate backward regression models.