3 south amer ica 90 and the united states 236 the

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non-Latin Caribbean, 75.3; South Amer- ica, 9.0; and the United States, 23.6. The median rate of psychiatric beds in general hospitals per 100 000 in the Americas is 1.7; in Mesoamerica, 0.2; the non-Latin Caribbean, 4.7; South America, 0.3; and the United States, 11.5. The median rate of community residential facility beds per 100 000 in Mesoamerica is 0; the non-Latin TABLE 2. Twelve-month prevalence of mental disorders in studies that have service utilization data Disorder Argentina WMHS Brazil WMHS Canada CCHS Chile CPPS Colombia WMHS Guatemala CIDI Mexico WMHS Peru WMHS USA NCS-R Field work 2015 2005–2008 2002 1992–1999 2003 2009 2001–2002 2004–2005 2001–2003 Age 18 ≥ 18 ≥ 15 ≥ 15 ≥ 18–65 18–65 18–65 18–65 18 ≥ Sample size 3 927 5 037 38 492 2 978 4 426 1 452 5 782 3 930 9 282 Diagnosis DSM-IV DSM-IV DSM-IV DSM-III-R DSM-IV DSM-IV DSM-IV DSM-IV DSM-IV Anxiety disorders 9.4 19.9 4.7 9.3 14.4 2.1 6.6 7.9 18.1 Affective disorders 5.7 11.0 5.2 9.9 7.0 1.4 4.8 3.5 9.5 Substance use disorders 2.4 3.6 11.0 10.4 2.8 3.0 2.5 1.7 3.8 Any 14.8 29.6 18.7 17.0 21.0 7.2 12.1 13.5 26.2 Severe 3.7 10.0 4.4 6.9 4.9 2.0 3.7 2.3 5.8 Moderate 5.3 9.8 6.0 6.9 8.6 1.1 3.5 5.6 9.8 Mild 5.8 9.8 8.3 3.2 7.5 4.1 4.9 5.6 10.5 Source: Prepared by the authors from the study results and in part from the following references 22 – 27. CIDI, Composite International Diagnostic Interview; CCHS’, Canadian Community Health Survey; CPPS, Chile Psychiatric Prevalence Survey; DSM, Diagnostic and Statistical Manual of Mental Disorders; NCS-R, National Comorbidity Survey-Revised; WMHS, World Mental Health Survey TABLE 3. Twelve-month prevalence of mental disorders by regions Disorder Americas North America Latin America Mesoamerica South America Weighted mean Anxiety disorders 14.7 16.7 13.2 6.1 16.2 Affective disorders 8.3 9.1 7.7 4.4 9.0 Substance use disorders 3.8 4.5 3.2 2.6 3.5 Any 22.7 25.4 20.7 11.5 24.4 Severe 6.1 5.7 6.4 3.5 7.6 Moderate 8.0 9.4 7.0 3.2 8.5 Mild 8.5 10.3 7.2 4.8 8.3 Mean Anxiety disorders 10.3 11.4 9.9 4.4 12.2 Affective disorders 6.4 7.4 6.2 3.1 7.4 Substance use disorders 4.6 7.4 3.8 2.8 4.2 Any 17.8 22.5 16.5 9.7 19.2 Severe 4.9 5.1 4.8 2.9 5.6 Moderate 6.3 7.9 5.8 2.3 7.2 Mild 6.6 9.4 5.8 4.5 6.4 Median Anxiety disorders 9.3 11.4 9.3 4.4 9.4 Affective disorders 5.7 7.4 5.7 3.1 7.0 Substance use disorders 3.0 7.4 2.8 2.8 2.8 Any 17 22.5 14.8 9.7 17.0 Severe 4.4 5.1 3.7 2.9 4.9 Moderate 6.0 7.9 5.6 2.3 6.9 Mild 5.8 9.4 5.6 4.5 5.8 Source: Prepared by the authors from the study results.
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Rev Panam Salud Publica 42, 2018 5 Kohn et al. • Treatment gaps in mental health care Original research Caribbean, 2.8; South America, 0.8; and the United States, 15.2. Access to basic medications remains an issue in some countries of Latin America; for example, in Peru antidepressants and antipsychot- ics were available in about two-thirds of hospitals and less than 20% of health cen- ters and small health clinics (44). The treatment gap for children and ad- olescents across the Americas is alarming, ranging from 64% – 86%. The need to address mental health services and im- prove access to care for children has re- ceived little attention. A report from Mexico highlights the issues facing Latin America (45). The infrastructure for child mental health care is lacking in both material and workforce resources, in par- ticular, a lack of child psychiatrists and training programs for child and adoles- cent mental health providers. Primary care providers have no training to detect mental disorders in children. Further- more, mental health services in Mexico
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