Avalere Health
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Insights

Mar 09, 2016

New Analysis Finds Individuals with Major Depressive Disorder Face Multiple Barriers to Optimal Care

Avalere and Mental Health America (MHA) developed a white paper to describe the current state of quality of care for individuals with major depressive disorder (MDD), provide an evidence-based assessment of challenges, and highlight potential opportunities for quality improvement.

Each year, MDD, a serious mood disorder, poses a significant challenge to the health and quality of life of millions of Americans and their families. Although MDD affects 6.6 percent of American adults aged 18 and over, evidence suggests that the medium time for individuals to receive treatment is four years after the onset of their symptoms, hindering their ability to advance toward recovery.1,2 Delayed treatment of MDD also increases the burden of disease on society, with overall economic losses estimated at $210.5 billion.3 While there have been attempts to address this growing burden, barriers to high-quality care persist.

Given this landscape, Avalere and MHA conducted a structured literature review and key informant interviews to identify barriers to high-quality care and proposed solutions. 

The authors identify the following barriers:

  • Stigma associated with mental illness;

  • Limited access by individuals to qualified mental health providers; 
  • Lack of specialized training for primary care providers in mental health;
  • Limited reimbursement for non-physician healthcare professionals, such as nurse practitioners and physician assistants;
  • Infrequent use of clinical practice guidelines by providers for clinical decision-making;
  • Inconsistent provider use of available scales to measure depression severity;
  • Lack of assessment and monitoring tools and quality measures that evaluate outcomes that matter to patients; and 
  • Low levels of awareness among individuals and families of available support services and online self-management tools.

The literature review and key stakeholder interviews identify a number of proposed solutions to enhance the timeliness and effectiveness of care. In addition, Avalere and MHA outline further recommendations to address challenges in MDD care. We envision that the tactics proposed in this paper will offer opportunities for all healthcare stakeholders to advance high-quality, person-centered MDD care.

Access the full white paper here.

Funding for this analysis was provided by the Takeda/Lundbeck Alliance. Avalere and MHA maintained full editorial control.

For additional insights on MDD care gaps and how these may affect your business, contact Judit Illes at JIlles@avalere.com or Kelsey Jones at KJones@avalere.com. 

1. Substance Abuse and Mental Health Services Administration. Mental Disorders. 2015. http://www.samhsa.gov/disorders/mental

2. Wang PS, Berglund P, Olfson M, et al. Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 Jun;62(6):603-13.

3. Greenberg PE, Fournier AA, Sisitsky T, Pike CT, Kessler RC. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry. 2015 Feb;76(2):155-62.

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