Mental Health Treatment Histories, Recovery, and Well-being

Epidemiological and sociological research on recovery from mental disorder is based on three rarely tested medical model assumptions: (1) recovery without treatment is the result of less severe illness, (2) treatment predicts recovery, and (3) recovery and well-being do not depend on individuals' treatment histories. I challenge these assumptions using National Comorbidity Survey-Replication data for individuals with any disorder occurring prior to the current year (N = 2,305). Results indicated that (1) untreated remissions were fully explained by less serious prior illness, (2) treated individuals were less likely to recover due to more serious illness, and (3) people who had past-only treatment were more likely to recover than the never-treated, while those in recurring and recently initiated care were less likely to recover. Treatment histories predicted greater well-being only if recovery had been attained. Histories of care help to explain recovery rates and suggest new directions for treatment-seeking theory and research.