Prevalence, comorbidity, disability and service utilisation

BACKGROUND: Health planning should be based on data about prevalence, disability and services used. AIMS: To determine the prevalence of ICD-10 disorders and associated comorbidity, disability and service utilisation. METHOD: We surveyed a national probability sample of Australian households using the Composite International Diagnostic Interview and other measures. RESULTS: The sample size was 10 641 adults, response rate 78%. Close to 23% reported at least one disorder in the past 12 months and 14% a current disorder. Comorbidity was associated with disability and service use. Only 35% of people with a mental disorder in the 12 months prior to the survey had consulted for a mental problem during that year, and most had seen a general practitioner. Only half of those who were disabled or had multiple comorbidity had consulted and of those who had not, more than half said they did not need treatment. CONCLUSIONS: The high rate of not consulting among those with disability and comorbidity is an important public health problem. As Australia has a universal health insurance scheme, the barriers to effective care must be patient knowledge and physician competence.