Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study

Coombs, Nicholas; Meriwether, Wyatt Edward; Caringi, James; Newcomer, Sophia R.

doi:10.1016/j.ssmph.2021.100847

Cited by 124 publications

(83 citation statements)

References 45 publications

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“…Individuals may be better able to afford behavioral health services in a clinic where they have been successful in receiving medical services already. Reduction of structural barriers is highly relevant in light of the body of research suggesting structural barriers interfere with accessing care to a greater degree than attitudinal barriers (Chen et al, 2013; Cohen Veterans Network, 2018; Coombs et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…Inpatient care, intensive outpatient treatment, and psychiatry are excluded from this definition of SMH. Data speaking to the relative importance of structural and attitudinal barriers to mental health treatment generally suggest that structural barriers, such as cost and clinic access, are more prohibitive than attitudinal barriers, such as stigma and mental health help-seeking attitudes, though these retain a notable influence (Chen et al, 2013; Cohen Veterans Network, 2018; Coombs et al, 2021). The American Psychological Association (APA) Presidential Task Force on Immigration (2013) classifies the myriad barriers to mental health treatment into contextual-structural, social-cultural, and clinical-procedural categories.…”

Section: Barriers To Specialty Mental Health Treatmentmentioning

confidence: 99%

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Barriers to integrated primary care and specialty mental health services: Perspectives from Latinx and non-Latinx White primary care patients.

Anastasia¹

2023

Psychological Services

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Significant disparities in access to mental health care exist in the current mental health system; integrated primary care (IPC) offers an alternative model of service delivery with initial evidence for reducing disparities. Little is known about whether, and how, IPC reduces barriers to mental health services. Here we report on a set of three studies using mixed methodology to explore the perceptions of potential recipients of care regarding barriers to accessing mental health treatment by setting (IPC or specialty mental health [SMH]) and ethnicity (Latinx or non-Latinx White). In Study 1, a main effect of setting indicated IPC patients perceived fewer barriers to accessing IPC than SMH. A setting by ethnicity interaction revealed Latinx patients perceived greater barriers to SMH than non-Latinx White patients. In Study 2, data from qualitative interviews suggested IPC patients found behavioral health treatment in IPC to be accessible and satisfactory. In Study 3, a non-treatment-seeking sample did not endorse a difference in barriers by setting or ethnicity. Overall, it appears IPC patients perceive behavioral health treatment delivered in primary care to be satisfactory, beneficial, and successful in reaching individuals with mental health need who otherwise may not receive care. Non-treatment-seeking individuals with lower psychiatric distress did not identify a difference in barriers between IPC and SMH settings. Findings are consistent with the potential of the IPC setting for reducing barriers to care, although key elements of IPC may need to be addressed to increase acceptability across all population subgroups. Impact StatementThe current set of studies examined integrated primary care (IPC) patients' perceptions of barriers to accessing mental health care in IPC and specialty mental health (SMH) settings. Latinx and non-Latinx White IPC patients perceived fewer barriers to care in IPC than SMH, while a non-treatment-seeking community samples saw no differences in barriers to care across settings. Results generally support the benefits of offering behavioral health services in IPC settings.

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Section: Discussionmentioning

confidence: 99%

Section: Barriers To Specialty Mental Health Treatmentmentioning

confidence: 99%

Barriers to integrated primary care and specialty mental health services: Perspectives from Latinx and non-Latinx White primary care patients.

Anastasia¹

2023

Psychological Services

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“…Both patients and providers identified cost as a barrier to accessing services. This perspective is not unique to NYC; it is in alignment with national studies that have identified affordability as a prevalent barrier to mental health access and a key attribute that patients are mindful of (Coombs et al, 2021). Specifically, one patient said, "I don't have funds for a $250 therapy session.…”

Section: What Patients Consider When Selecting a Providermentioning

confidence: 95%

Availability and Accessibility of Mental Health Services in New York City

Breslau¹,

Barnes-Proby²,

Bhandarkar³

et al. 2022

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In this report, the research team provides findings from a project that aims to assess the needs for mental health services in New York City by compiling data on mental health providers and conducting interviews with diverse stakeholders. The project will inform stakeholders about how the city government can strategically and effectively improve current system factors that influence mental health care access, particularly for underserved populations.

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“…The most commonly reported barrier to accessing regular healthcare services in our study population was costs of health services, also among persons suffering from MHCs. Affordability of health services has been reported as one of the major barriers to access in previous studies undertaken in Europe, South Africa, and the US [42][43][44] . However, health insurance coverage is only one dimension in the barrier complex with regard to healthcare 45,46 .…”

Section: Barriers To Health Care Servicesmentioning

confidence: 99%

Mental health of people without access to health services: a retrospective study of patients attending a humanitarian clinic network in Germany in 2021

Mugambwa

Lutchmun

Gach³

et al. 2022

Preprint

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Background: Germany has a statutory health insurance system. However, a substantial part of the population still suffers from limited access to regular health services. While humanitarian organizations are partially filling this gap, people without regular access show a high prevalence of mental health conditions (MHCs). This study investigates the prevalence and social determinants of MHCs in patients attending the clinics of a humanitarian health network in three major cities in Germany, as well as potential barriers to healthcare access in this population. Methods: We performed a descriptive, retrospective study of adults attending the outpatient clinics of the humanitarian organization Ärzte der Welt, in Berlin, Hamburg and Munich, in 2021. Medico-administrative data was collected using a digital questionnaire at first presentation to the clinics. We report the prevalence of both subjective and diagnosed MHCs and the perceived barriers to healthcare access in this population. We performed a logistic regression analysis to identify the socio-demographic factors associated with high risk of MHCs. Results: Our study population consisted of 1,071 first presenters to the clinics in 2021. The median age at presentation was 32 years and 57.2% of the population were male. 81.8% experienced a form of homelessness, 40% originated from non-EU countries and only 12.4% had regular statutory health insurance. 101 (9.4%) patients had a mental health diagnosis. In addition, 128 (11.9%) patients reported feeling depressed, 99 (9.2%) reported a lack of interest in daily activities, and 134 (12.5%) lacked emotional support in situations of need on most days. The most reported barrier to accessing health services was high health expenses, reported by 61.3% of patients. In the bivariate analysis we found significant associations for MHCs with age, insurance status and region of origin. Conclusions: People without access to regular health services have a high need for mental health services. As a chronic condition, this is even more difficult to manage outside of regular services, where humanitarian clinics are only filling the gap in serving basic health needs.

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Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study

Cited by 124 publications

References 45 publications

Barriers to integrated primary care and specialty mental health services: Perspectives from Latinx and non-Latinx White primary care patients.

Barriers to integrated primary care and specialty mental health services: Perspectives from Latinx and non-Latinx White primary care patients.

Availability and Accessibility of Mental Health Services in New York City

Mental health of people without access to health services: a retrospective study of patients attending a humanitarian clinic network in Germany in 2021

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