4 in 10 US adults who need mental health services don’t have access to them

Respondents to a recent survey said barriers to mental health services included cost, availability, wait times, lack of diversity and proximity to care. Photo by tiyowprasetyo/Pixabay

There is a “staggering” gap between the number of Americans who need care for anxiety, depression and other mental health issues and those who can actually get it, according to a new survey.

A total of 42% of American adults who needed care in the past 12 months did not receive it due to cost and other barriers, according to the National Council for Mental Wellbeing’s online survey. Almost a quarter said they needed help with substance use.

“Unfortunately, I think the data on difficulties in accessing care is not surprising,” CEO Chuck Ingoglia said. “We are in an environment where there is increased attention to these issues at the federal level and at the state level there have been efforts to compel insurance companies to provide adequate coverage for behavioral health issues, and yet it’s still a challenge for individuals, and that’s a real shame.”

The National Access to Care Survey, conducted by The Harris Poll in May, included 2,053 American adults. Respondents said barriers included cost, availability, wait times, lack of diversity, and proximity to care. The United States Surgeon General issued a similar warning late last year for young Americans.

In the new survey, around 21% said they had difficulty accessing primary health care when they needed it, but more than twice had difficulty getting needed mental health or addictions treatment.

Ingoglia warned that the problem would get worse without intervention.

About 37% of respondents who said they needed mental health care in the survey said expenses had prevented them from getting it, whether it was out-of-pocket costs or lack of support. ‘insurance. This was also the case for 31% of those who needed addiction care.

Twenty-eight percent of respondents said they were unable to find a conveniently located provider, as did 22 percent of those who needed addiction care, the survey found.

Respondents also struggled to find a provider who offered care in a way they were comfortable with – whether in person or virtually.

“What we regularly see in many surveys, our own surveys, and what we hear is that Americans are concerned about their mental health and are struggling to access high-quality mental health treatment” , said Dr. Rebecca Brendel, president of the American Psychiatric Association (APA), who was not involved in the survey.

She noted that even before the COVID-19 pandemic upended “all the stabilizing institutions, connections and things that we all depend on for our well-being,” there was a shortage of providers. The mental health needs facing Americans with long-term COVID have only compounded the problem.

“We know Americans are in trouble,” Brendel said. “We saw an unprecedented number of opioid overdoses last year, over a hundred thousand, higher suicide rates, children reporting distress, parents concerned about their children, and Americans in general reporting a distress.”

It’s something, she says, that “we need to act on and we need to act quickly.”

The United States Centers for Disease Control and Prevention recently reported that deaths from drug overdoses set a new record last year.

In ways big and small, the fallout from lack of mental health care reverberates throughout people’s lives, experts noted.

About 50% of respondents said the lack of care led to problems with personal relationships. About 45% reported problems at work and 44% noted a decline in their mental well-being.

For those who needed but were unable to get addiction care, 49% reported work problems as a result, 43% cited relationship problems and 37% a decline in mental well-being.

“As the survey showed, people then report challenges in important areas of their lives, whether it’s related to their relationships or their work, their general functioning,” Ingoglia said. “These are diseases that end up disrupting many areas of a person’s life.”

Men were more likely than women to need addiction care, according to the survey. People aged 18 to 41 were more likely than older people to need both mental health care and addictions care.

Cultural issues were a major concern. About six in 10 adults agreed that there are too few mental health providers trained to deal with issues specific to race, ethnicity, sexual orientation or economic status.

“An ongoing question that our country needs to think about is how to not only increase the number of behavioral health professionals, but continue to ensure that people entering the field look and can relate to people who need a treatment?” said Ingoglia.

Even respondents who said they had access to care struggled to get what they needed, including 67% of those who received mental health care and 81% of those treated for substance abuse, the survey found.

Citing insurance-related issues, around three in five said they thought it would be easier and faster to get help if they paid for mental health care out of pocket.

Brendel, the APA leader, said it’s important people know what resources are available to them. For those who are employed, resources may be available at the workplace, for example.

She said many insurers were not complying with mental health parity legislation passed a decade ago.

“The cost of mental health and addictions care should not be higher or less affordable than general medical care,” Brendel said. “We’ve had national parity legislation for over a decade, and the biggest problem is that we’re struggling to enforce it.”

Certified community behavioral health clinics could be one solution, Ingoglia says. They are required to offer appointments quickly and serve everyone, regardless of their ability to pay.

But there’s a catch: These are only available through a federally mandated Medicaid demonstration in 10 states. Another 30 states have grant-funded programs, but those will only become sustainable if they become part of Medicaid, Ingoglia said.

“There is some hope that Congress will expand this program this year and make it available in every state across the country,” he said.

More information

The US Centers for Disease Control and Prevention has more on mental health.

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