Four countries, 25 years, far more antidepressants: the prevalence of depression and anxiety did not fall
Australia, Canada, England and the US, 1990 to 2015: "the prevalence of mood and anxiety disorders and symptoms has not decreased, despite substantial increases in the provision of treatment, particularly antidepressants."
Weak or heavily disputed. Treat as a question, not an answer. how we score evidence
Caveat on this rating: A review of repeated national surveys, which differ in instruments and response rates across waves and countries. The authors could not test whether greater willingness to disclose symptoms hides a real improvement.
Health planners call it the treatment gap: most people with a common mental disorder get no care, and closing the gap should make the disorders rarer. Four rich countries spent twenty five years closing it.
Significant findings
Jorm, Patten, Brugha and Mojtabai (World Psychiatry, 2017) reviewed the data "from 1990 to 2015" for "Australia, Canada, England and the US. These data show that the prevalence of mood and anxiety disorders and symptoms has not decreased, despite substantial increases in the provision of treatment, particularly antidepressants."
They tested the obvious rescue, that life got harder and treatment held the line: "There was no support for the hypothesis that reductions in prevalence due to treatment have been masked by increases in risk factors." A second rescue, that people now report symptoms more readily, could not be settled: "there was little evidence relevant" to it.
What they found most support for: "much of the treatment provided does not meet the minimal standards of clinical practice guidelines and is not targeted optimally to those in greatest need. Lack of attention to prevention of common mental disorders may also be a factor."
Their conclusion: "Reducing the prevalence of common mental disorders remains an unsolved challenge for health systems globally, which may require greater attention to the "quality gap" and "prevention gap"."
Worth asking
The finding is about populations, and the explanation the authors favour is about quality, not about the drugs being useless: a prescription with no follow-up, given to someone with mild distress, counts as treatment in these statistics and changes nothing in them. The question it leaves for one person is a practical one. Is anyone measuring whether you are getting better?
Source
Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries — Jorm AF, Patten SB, Brugha TS, Mojtabai R (2017)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1002/wps.20388
DOI: 10.1002/wps.20388
How this was scored
- Study design
- Narrative review
- Funding
- Funding not disclosed
- Published in
- Top-tier peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "contested". Weak or heavily disputed. Treat as a question, not an answer. It scores 36 out of 100 on our published rubric. One caveat travels with that badge: A review of repeated national surveys, which differ in instruments and response rates across waves and countries. The authors could not test whether greater willingness to disclose symptoms hides a real improvement. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries — Jorm AF, Patten SB, Brugha TS, Mojtabai R (2017). Published in: Top-tier peer-reviewed journal. DOI: 10.1002/wps.20388. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Narrative review. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.