What we conclude
In Australia's 2020–22 survey, the wait before first help for depression and anxiety was long: a median of 3 years for major depressive disorder and 11 years for any anxiety disorder among those who sought help (Birrell 2025). Yet we found no controlled study in which this time was the outcome. A 2026 review of 21 systematic reviews of complex early-intervention programmes for conditions that usually begin before 25 found "no reviews" on depression or anxiety (Lee 2026), and a second review of 11 reviews, from other authors and more databases, found the time to treatment measured as an outcome only for psychosis (Adu 2026). Programmes that encourage people to seek help are the nearest step that has been tested, and for depression and anxiety the evidence is weak: a review on depression, anxiety and distress found no effect on actually seeking help (Gulliver 2012), and a meta-analysis on depressive symptoms found a borderline result its authors read as no change (Ni 2025). A broader meta-analysis of 98 trials across all mental health problems found long-term gains in seeking professional help among people with or at risk of problems, but not among children, adolescents or the general public (Xu 2018).
What we will not claim
"We found no study" means no study in PubMed, Europe PMC and the two reviews of reviews; it is not proof that none exists, and service reports outside these databases (for example from youth services or self-referral programmes) may have measured the delay. A missing test does not mean the delay cannot be shortened. Lee 2026 covered only programmes with several components for conditions that usually start before 25, and searched four databases. The Australian medians count only people who eventually sought help, and the start of the disorder is what people recalled. The 98-trial meta-analysis mixes randomised and non-randomised trials and all kinds of mental health problems, and did not measure time to help either. This page does not say what anyone should do or when to seek help.
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What has been measured, and what has not
| Study | What it covers | Time to first help measured as the outcome? | Main result |
|---|---|---|---|
| Australian national survey, 2020–22, 15,893 people (Birrell 2025) | Delay among those who sought help | Described, not tested | Median 3 years (depression), 11 (any anxiety disorder), 13 (social anxiety) |
| Review of 21 reviews, 2019–2025 (Lee 2026) | Early intervention, conditions that usually begin before 25 | Only for psychosis | No reviews on depression or anxiety |
| Review of 11 reviews, 2015–2025, all ages (Adu 2026) | Early intervention services | Only for psychosis | For depression and anxiety, school programmes measured by symptoms |
| Meta-analysis of 98 controlled trials, 69,208 people (Xu 2018) | Programmes to encourage seeking help, all mental health problems | No | More contact with professionals among people with or at risk of problems; not in children, adolescents or the general public |
| Review of 6 randomised trials (Gulliver 2012) | Depression, anxiety, distress; mostly young adults | No | Better attitudes; no effect on actually seeking help |
| Meta-analysis of 13 studies (Ni 2025) | People with depressive symptoms | No | Intentions rose; authors conclude actual help-seeking did not change (borderline result) |
The rows measure different things and are not combined. Only the first row reports a delay; the others show where the evidence on shortening it stops. Medians count only people who eventually sought help.
How long people wait
In Australia's National Study of Mental Health and Wellbeing of 2020–22, among people who eventually made contact with help (first contact with a doctor or other professional about these symptoms), the median time from the start of the disorder was 3 years for major depressive disorder, 11 for any anxiety disorder, 13 for social anxiety disorder, 5 for generalized anxiety disorder and 2 for panic disorder (Birrell 2025). Our briefing on anxiety disorders (in the sources below) sets these figures beside surveys from other countries.
What the reviews found
A 2026 review of 21 systematic reviews of early intervention, searched from January 2019 to May 2025 and covering conditions that usually begin before 25, found reviews on psychosis, eating disorders, bipolar disorder and approaches across diagnoses; in the authors' words, "No reviews were found on early intervention for depression, anxiety, or 'personality disorders'" (Lee 2026). For psychosis, they found that "the success of initiatives to reduce duration of untreated symptoms is less consistent".
A second review of 11 reviews, by other authors, searched seven databases from January 2015 to June 2025 for any age. The time to treatment appears there as an outcome only for psychosis; for depression and anxiety it includes school programmes for 10- to 19-year-olds with symptoms, measured by change in symptoms, not by time to help (Adu 2026). An editorial in the British Journal of Psychiatry in 2026 calls shortening the untreated period in anxiety disorders a "neglected priority", synthesises the evidence and proposes measures (Olivola 2026). For psychosis itself, our briefing on early intervention services (in the sources below) shows that only one programme with a comparison group clearly shortened the time.
Getting people to seek help
Some studies measure a step close to the delay: whether people actually seek help. A meta-analysis of 98 randomised and non-randomised controlled trials with 69,208 participants found "positive long-term effects on formal help-seeking behaviours"; separately, programmes improved formal help-seeking when delivered to people with or at risk of mental health problems, "but not among children, adolescents or the general public" (Xu 2018).
Reviews focused on depression and anxiety are less encouraging. Across six randomised trials on depression, anxiety and distress, mostly in young adults, mental health literacy content improved attitudes to seeking help in most studies but "had no effect on help-seeking behaviour" (Gulliver 2012). A 2025 meta-analysis of 13 studies of people with depressive symptoms found that intentions to seek help rose right after the programme, while the authors concluded that actual help-seeking did not change (Ni 2025).
Large public campaigns against depression measured other things. In four European regions with a campaign and four without, people in campaign regions held less personal stigma about depression; time to help was not among the measures (Kohls 2017). The Nuremberg Alliance Against Depression measured suicidal acts (Hegerl 2006).
What does not fit
Two things pull against the picture above. First, the 2025 meta-analysis reports for actual help-seeking an odds ratio of 1.67 with a 95% interval of 1.05 to 2.94 and P = .05; an interval that does not include 1 usually means an effect, yet the authors conclude that help-seeking did not change (Ni 2025). The evidence on help-seeking in depression is therefore weak rather than clearly negative. Second, in the US survey of 2001–03, people from older generations waited longer before first contact (Wang 2005): people from younger generations waited less in that survey, but it cannot show why, and no programme has been tested as the cause.
How to quote this
Finding: among Australians who eventually sought help, a median of 3 years passed after major depressive disorder began and 11 years after an anxiety disorder began (Birrell 2025); we found no controlled study in which this time was the outcome, and two reviews of reviews found such evidence only for psychosis.
Limit: "not found" covers PubMed, Europe PMC and two reviews of reviews, not every service report; it does not show that the delay cannot be shortened.
Sources
- Birrell 2025, Epidemiology and Psychiatric Sciences
- Lee 2026, BMC Medicine
- Adu 2026, Frontiers in Public Health
- Xu 2018, Psychological Medicine (abstract)
- Gulliver 2012, BMC Psychiatry (abstract)
- Ni 2025, BMC Psychiatry (abstract)
- Olivola 2026, British Journal of Psychiatry (abstract)
- Kohls 2017, Journal of Affective Disorders (abstract)
- Hegerl 2006, Psychological Medicine (abstract)
- Wang 2005, Archives of General Psychiatry (abstract)
- NOOS Institute 2026, 11 years from symptoms to help? Among those who sought it, it differs by disorder: anxiety 11, mood 3 (Australia, 2020–22)
- NOOS Institute 2026, Duration of untreated psychosis: early intervention rarely shortens it, though it helps those who reach it