A study published this week by the JAMA Internal Medicine has shown that most Americans who are screened and diagnosed with depression don’t receive treatment.

Conversely, many  who did receive treatment don’t actually appear to have the disorder.

Mark Olfson MD, professor of psychiatry at the Columbia University Medical Center and lead author of the study “Over the last several years there has been an increase in prescription of antidepressants. In that context, many people assumed that under-treatment of depression is no longer a common problem.”

The study found the opposite results after analyzing data from Medical Expenditure Panel Surveys in 2012 and 2013.

The study asked people if they had been screened for depression. Out of the 46,417 adults surveyed, 8.4 percent provided answers that suggested they would be diagnosed with depression. However, only 28.7 percent of the people who appeared depressed received any treatment for it.

“The findings highlight that there are continuing challenges in aligning depression care with patient needs,” Olfson says.

The study also found that those in the lowest-income group were five times more likely to appear to have depression compared with those in the highest income group. 18.2 percent of lowest-income adults screening positive compared to 3.7 percent of the highest-income group.

Female, white, non-Hispanic participants had at least a high school education or had health insurance were more likely to get treatment if they were diagnosed as depressed. People with low incomes, uninsured adults, racial and ethnic minorities and men were less likely to be treated.

“Being a little less aggressive in medication in mild depression would be beneficial,” Dr Olfson explained, “There are simpler forms of psychological interventions that can be adapted for primary care.”

Patients with mild depression could first be given nondrug treatments ranging from counseling and exercise to yoga, the researchers say.

And although the study found that those with serious psychological distress are more likely to be treated by psychiatrists instead of general medical professionals, that wasn’t the case for older patients, African-Americans, the uninsured or those with less education.

Most people with untreated depression make at least one visit to a primary care doctor annually. Dr Olfson suggests those visits could be used to screen people in disadvantaged populations, ideally offering them mental health treatment at the primary care clinic level.

“Depression really is a serious condition and we’re finding that so many Americans aren’t receiving care,” he adds. “I hope that [this study] brings attention to this situation.”