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The aim of this paper is to reveal these problems and to derive recommendations for improvement. In the field of alcohol use disorders (AUDs), two common complaints are the large treatment gap that exists because only a small percentage of people with an AUD are in treatment; and the prolonged lag that typically exists between the emergence of problematic symptoms and actual on set of treatment. However, there also are no clear definitions for these terms – “treatment gap” and “treatment lag” – and, therefore, no consensus regarding how to quantify them. For this reason, it is difficult to compare the results of studies assessing either of these measures.

A non-systematic literature search and logical-analytical investigation was performed of immanent problems related to definitions and measurements aiming to enhance understanding in this area and derive suggestions for improvement.

The following four fundamental questions were identified: How does one operationalise the need to change substance use behaviours? Which interventions can justifiably be called treatment? Is treatment always necessary? and How regularly do patients need to be in contact with a treatment system to be considered “in treatment”? Potential approaches to answering these questions are discussed and recommendations made for future studies to determine how the treatment gap and treatment lag should be derived.

The derived recommendations should make the calculation of treatment gap and treatment lag more transparent and comparable between studies. They also may serve as checklists for future studies on the treatment gap and lag in the AUD field.

We design experimental economies based on a New Keynesian Dynamic Stochastic General Equilibrium (DSGE) model. We apply shocks to tastes, productivity, and interest rate policy, and measure the persistence of these shocks. We find that, in a setting where goods are perfect substitutes, there is little persistence of output shocks compared to treatments with monopolistic competition, which perform similarly irrespective of whether or not menu costs are present. Discretionary central banking is associated with greater persistence than automated instrumental rules.

Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse treatment provision among individuals of varying socioeconomic and racial/ethnic backgrounds. This study investigates that achievement by analyzing the relationship between community socioeconomic and racial/ethnic disadvantage and organizational provision of substance abuse treatment, treatment need and utilization across United States counties, 2000, 2002 and 2003. Results confirm equity in service provision in poorer communities and those with higher concentrations of African Americans. Significant disparities remain, however, in communities with higher concentrations of Hispanics, youth and female-headed households. Limitations and implications for future studies of health care provision are discussed.

This paper describes the finite element solution of conjugate heat transfer problems with and without the use of gap elements. Direct and iterative methods to incorporate gap elements into a general finite element program are presented, along with their advantages and disadvantages of the two gap element treatments in the framework of finite elements. The numerical performance of the iterative gap element treatment is discussed in detail in comparison with analytical solutions for both 2‐ and 3‐D gap conductance problems. Numerical tests show that the number of iterations depends on the non‐dimensional number Bi = hL/k, and it increases approximately linearly with Bi for Bi≥0.6. Here, for gap heat transfer problems, h is taken to be the inverse of the contact resistance. This conclusion holds true for both 2‐ and 3‐D problems, for both linear and quadratic elements and for both transient and steady state calculations. Further numerical results for conjugate heat transfer problems encountered in heat exchanger and micro chemical reactors are computed using the gap element approach, the direct numerical simulations and analytical solutions whenever solvable. The results reveal that for the standard heat exchanger designs, an accurate prediction of temperature distribution in the moving streams must take into consideration the radial temperature distribution and the accuracy of the calculations depends on the non‐dimensional number Bi = hR/2k. From gap element calculations, it is found that classical analytical solutions are valid for a heat transfer analysis of an exchanger system, only when Bi<0.1. This important point so far has been neglected in virtually all the textbooks on heat transfer and must be included to complete the heat transfer theory for heat exchanger designs. Results also suggest that for thermal fluids systems with chemical reactions such as micro fuel cells, the gap element approach yields accurate results only when the heat transfer coefficient that accounts for the chemical reactions is used. However, when these heat transfer coefficients are not available, direct numerical simulations should be used for an accurate prediction of the thermal performance of these systems.

Many pupils who experience distress and emotional difficulties are left untreated because of the shortage of mental health professionals at schools. This study aims to explore a brief psycho-educational intervention based on school psychologist–teacher cooperation aimed at closing this treatment gap.

With a randomized controlled methodology, 79 preschools to 12th grade teachers were asked to lead a brief psycho-educational intervention with one of their pupils. A second pupil was assigned to a waiting list (control group). Each teacher and one of her/his colleagues filled a Pupil Adjustment questionnaire, being developed for this study, before and after the intervention.

The findings show that the intervention significantly improved the adjustment of the participating pupils, compared to the control group. That improvement related to all the dimensions of adjustment (i.e. social, protection and learning).

Teacher–school psychologist cooperation, as described here, is hardly practiced. It emerges as an effective model to assist many pupils who are currently left with no treatment. The discussion traces the next stages for outreaching that would apply to pupils in many countries and cultures.

The purpose of this paper is to draw attention to inherent barriers to help-seeking, particularly those caused by increased globalization and diversification of our societies. It explores the underutilization of mental health resources by ethnic minority groups while highlighting some alternative treatment approaches with growing evidence bases.

Using a literature review and comparative analysis of relevant studies, the author makes a case for increased adoption of alternative therapies; citing the evidence base for the most promising treatments which include exercise therapy, mindfulness-based therapies, yoga for depression and spirituality-based therapies. It further compares the efficacy and advantages of these therapies with common mainstream therapies.

In comparison, some alternative treatment modules are just as effective, if not better than traditional, mainstream therapies for certain ailments. In conclusion, the paper calls for increased research on the efficacy of alternative therapies; and beckons service providers to explore the potential for these therapies to bridge the gap in treatment towards a more inclusive and client-centered mental health care.

The author provides a plethora of thought-provoking ideas in this article. For instance, he tendered a different outlook on barriers to treatment by differentiating between accessibility challenges versus underutilization. He also highlights the critical impact of Eurocentrism as a contributor to barriers to treatment utilization.

The purpose of this case study is to describe the experiences of a development organization operating in Africa to make mental health services accessible to communities in Kenya and Uganda through partnerships. The lessons that can be learnt from this work are also considered.

The paper is a case study that builds on operations research gathered over five to seven years by the authors who have managed the country mental health programmes in Uganda and Kenya. The case study describes the problem of mental illness and its magnitude in Kenya and Uganda, and why it is important that this is addressed. Existing mechanisms in place and gaps in current service provision are also discussed.

Methods used to address gaps in current service provision include capacitating different service providers, their roles and their contribution to community mental health. The inclusion and training of non‐psychiatrists can contribute to the management, treatment and recovery of people with mental health problems in African communities.

The case study is limited in its applicability in full to other low to middle income countries (LMICs). Causality cannot be established between improvement in access and training of the different health service providers.

The case study gives practical experiences that practitioners in LMICs can further test in improving access to community‐based mental health services. These experiences can help to form a promising practice in how LMICs can reduce health workforce gaps in mental health and planners can consider using this to reduce such gaps.

The case study shows how the participation of service users and other stakeholders and using family resources can bring ownership and sustainability of mental health care at the community level.

The case study adds value to practice and social development theories and models of care.

Closing the treatment gap in depression is vital to prevent people from losing their jobs. Delivering group-based interventions at work could reach more employees than delivering 1:1 interventions in a clinical setting. This study aims to redesign a Treatment Programme to make it more acceptable and accessible for employees with depression.

A mixed-methods exploratory sequential design with a high level of stakeholder consultation was used to redesign an interdisciplinary Work-focussed Relational Group CBT Treatment Programme for moderate-severe depression. Qualitative data from focus groups and quantitative data from a small feasibility study were integrated to develop the new Training (and Staff Support) Programme (TSSP), which was fully specified and manualised in line with the Template for Intervention Description and Replication (TIDieR) for future delivery.

Focus groups identified a need for improved acceptability and accessibility of the tertiary preventative Work-focussed Relational Group CBT Treatment Programme. This programme was, therefore, simplified for delivery by peer facilitators at the worksite as an intervention for all employees rather than an indicated/targeted intervention for only those with symptoms/risk of depression. The TSSP comprised a compulsory trauma-informed educational/experiential workshop over four days plus optional open-ended, peer-led base groups set up and run by volunteer peer facilitators.

The focus groups comprised a convenience sample who knew the researchers as a colleague or therapist, so there is a risk of selection or relationship bias. They were not involved in the data analysis which undermines the element of co-production and increases the risk of analytic or confirmation bias.

Delivering the new intervention in a group format will require peer facilitators to acquire skills in co-facilitation using a structured-directive leadership style and an awareness of the potential side effects of group-based interventions.

The worksite TSSP provides a democratic learning space and empowers employees to stay at work by self-managing their symptoms and by challenging the interpersonal dynamics and organisational structures that might precipitate and perpetuate depression.

This intervention is fully specified and manualised with an explicit programme theory, unlike most universal worksite-based CBT programmes.

There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to compare the pathways to care among patients with co-occurring disorder and those with only substance use disorders.

A cross-sectional observational study was carried out on male treatment seekers at a tertiary care substance use disorder treatment center in India. Participants were recruited in two groups, those with co-occurring psychiatric and substance use disorders and those with only substance use disorders. The two groups were matched for age and socio-economic status.

A total of 189 subjects with co-occurring psychiatric and substance use disorders and 197 subjects with substance use disorders only were recruited. Psychiatric services were the most common first point of care. However, a larger proportion of the subjects in the co-occurring disorder group received the first care from faith healers, while a greater proportion received first care from the therapeutic communities in substance use disorder only group. Initial care was sought mostly following suggestion from the family members in both the groups. The time to treatment for substance use disorders did not differ between the two groups, though the treatment seeking for substance use disorder was more delayed than that of psychiatric disorder in the co-occurring disorder group.

The findings shed light on the pathway of care followed in India and is a matter of further research.

Expansion of services and dissemination of information about psychiatric disorders and substance use disorders can provide timely care to patients with substance use disorders and co-occurring disorders.

The findings have a social implication as well. More awareness is needed currently in India for timely treatment of dual disorders.

The paper is an original research by the authors. The data were collected from the participants who reported to the dual diagnosis clinic. The findings are important as they tell us about the current understanding of dual diagnosis by the general public.

The paper covers:• nature of the drug problem ‐ drug dependence, prevalence of misuse, distribution of problematic drug‐users (PDUs) across NOMS and how drug‐related offending manifests itself• drug strategy in prisons ‐ demand reduction, supply reduction and establishing through‐care linkages, clinical services, counselling, assessment, referral, advice and through‐care services (CARATs), drug rehabilitation programmes, drug testing programmes, supply reduction initiatives, DIP linkages and wider resettlement agenda• assessing need and planning for the future ‐ needs analysis, development of the collaborative drug treatment vision, initiatives planned or under way to improve quality and amount of treatment available, and mainstreaming/integration of services to reduce re‐offending and make public environment safer.