What if I needed help? Population preferences for first-line mental health treatments in the post-COVID time

Treatment guidelines for mental disorders recommend psychotherapy, psychopharmacology, or both as first-line treatments. However, it remains unclear to what extent these recommendations align with public treatment preferences. While treatment preferences are central in patient-centred care, it remains unclear, whether persons would choose recommended first-line treatments. Understanding these preferences may reveal gaps between recommendations and public perception.

2,125 participants (48% female) in Germany completed an online survey about preferred treatment modalities in the case of a personal mental disorder. Linear-mixed effects models examined variation in preferences across disorders. Post-hoc comparisons contrasted psychotherapy and psychopharmacology across disorders. Sociodemographic and clinical predictors were examined.

About 36% of respondents reported previous treatment experience. The majority preferred psychotherapy over psychopharmacology. While psychotherapy was favoured across different mental health conditions, the extent of this preference varied depending on the specific disorder. The strongest preference for psychotherapy over psychopharmacological treatment was observed for depression, whereas the smallest difference was found for psychotic disorders, despite the central role of pharmacological treatment. Participants who were female, had prior treatment experience, or were employed in the healthcare sector were less likely to prefer pharmacological treatment.

The findings reveal a strong preference for psychotherapy over psychopharmacological treatment and highlight discrepancies between guideline-recommended treatments and public preferences, the underlying reasons of which were not examined in the present study. Increasing the availability of psychotherapy, in line with both guidelines and public preferences, appears warranted.