That's a good point. The delay varies wildly from place to place. In the US, if you have good medical coverage, you can get a diagnosis and start treatment in a month or two. In Western Europe -- partly because of the nature of their medical system but also because of their much greater cultural skepticism towards medication -- the wait can indeed be years. This partly kept me from accepting a job I badly wanted in Copenhagen.

Even when you have the diagnosis and medication, getting effective treatment can by itself take years. The person taking the medication needs to understand its effects and be able to tell the doctor, in a manner that makes medical sense, "no, this doesn't work" when it doesn't work. I, for instance, suffer from overwhelming bouts of uncontrollable rage when I take Ritalin. The resulting damage has never been inflicted directly on the people around me, but it has strained or broken relationships and cost me thousands of dollars, at times when those costs were particularly onerous. One might expect this side effect to be immediately obvious, but it wasn't. I figured it out years after it started.

In turn, I had to notice for myself (a) that amphetamine salts are not the same thing as Adderall and (b) that I was incapable of functioning when I was taking them. I then (c) had to bring this up with my doctor, and (d) be able to point out that I had been fine six months prior, when I was taking brand-name Adderall XR (fortunately, because I have severe ADHD, I hadn't disposed of old rx bottles). She then discovered that my monthly urinalysis results had shown, since my pharmacy switched me to amphetamine salts, that I was excreting none of the expected amphetamine metabolites. As far as the urinalysis was concerned, I wasn't taking an amphetamine at all. ("Yes, dr, I have been taking the drug daily. No, I haven't been selling it.") So she then had all the information she needed in order to make the judgment that I needed a different drug.

Effective treatment of psychiatric conditions, in other words, can depend to a great extent on the ability of the patient to recognize, evaluate, and demand effective treatment. Novice patients rarely know how to do that.