Increasing mental health treatment but stable prevalence rates: Towards a better understanding of the difference between epidemiological disorder prevalence and treatment prevalence

In high-income countries, psychiatric treatment prevalence has been increasing for many years. In recent years, developments in autism and attention-deficit hyperactivity disorder have received considerable attention in both health policy and research. At the same time, the epidemiological prevalence of mental disorders is not increasing, with the exception of adolescents and young adults. In this contribution, we explore how the difference between epidemiological disorder prevalence and treatment prevalence can be better understood. To this end, we first provide an overview of the different types of prevalence and their methodological backgrounds. In this regard, we propose the thesis that the disorder prevalence is only partially related to the increase in treatment prevalence. The treatment prevalence is largely determined by sociocultural factors and only secondarily by medical aspects. We then present a theoretical model that addresses the sociocultural characteristics that exist on both the supply side (service providers) and the demand side (patients, service users). In this context, we distinguish between conceptual issues, characteristics of the healthcare system, and macrosocial and microsocial characteristics.