Mental disorders – who and what might help

Background Research on lay public’s attitudes toward the treatment of mental disorders is receiving increasing scientific attention. Most of the surveys on lay public attitudes have used rating approaches. However, in daily life, people are forced to make decisions. Therefore, we used a ranking approach to elucidate preferences of the lay public, aiming to reflect the real life decision-making process. Objective We investigated preferences of the lay public regarding sources of help and treatment options in case of mental disorder. Methods In the spring of 2001, a representative survey was carried out in Germany (n=5015). A personal fully structured interview was conducted which started with the presentation of a vignette depicting someone with either schizophrenia or major depression. Respondents were asked to make first and second choices regarding the recommendation of source of help and treatment. Furthermore, socio-demographic characteristics and illness behaviour as possible determinants were assessed and analysed using logistic regression. Results Even though most of the people advise professional help, especially from mental health professionals, a large gap remains between evidence-based treatment strategies and public opinion. Psychotherapy is by far the most favoured treatment. In contrast, psychotropic drug treatment was only suggested by the minority for firstchoice treatment. Certain beliefs concerning illness and socio-demographic characteristics are associated with specific recommendations regarding source of help and treatment. Conclusion The consequences are twofold. First, as mental health professionals are dealing with non-compliance especially to psychotropic drugs, they have to realise that basic beliefs and expectations may play a more prominent role than has been previously assumed. Consequently, they have to put far more effort into what is called psychoeducation. Secondly, public knowledge about mental disorders and their treatment strategies has to be enhanced by working with the mass media and looking for other tailored interventions.