ABSTRACT
Over a period of 50 years, community surveys of mental disorders (Leighton, 1959; Robins & Regier, 1991; Srole & Fischer, 1980), culminating in the World Mental Health Initiative described in the previous chapter, have built solid evidence that mental disorders are common, often disabling, under-recognized, and under-treated. Although these surveys are sometimes criticized for overstating the significance of mental disorders in population health, a good argument can be made that they actually understate it. With notable exceptions, e.g., Rutter, Tizard, Yule, Graham, and Whitmore (1976), these surveys rarely include children or elderly people, and lifetime (as opposed to current) prevalence is seriously underestimated due to problems of recall over long periods (Susser & Shrout, 2010). With few exceptions (Phillips et al., 2009), severe but less common disorders, such as schizophrenia and autism, cannot be detected reliably by most community surveys, yet these conditions are often disabling over a long period and have an impact on the lives of the patient’s family and other caregivers as well as the patients themselves.
