Trends in Contacts with Mental Health Professionals and Cost Barriers to Mental Health Care Among Adults with Significant Psychological Distress in the United States: 1997-2002

Overview

Journal Am J Public Health

Specialty Public Health

Date 2005 Oct 1

PMID 16195533

Citations 46

Authors

Ramin Mojtabai

Affiliations

Soon will be listed here.

Abstract

Objectives: I assessed recent trends in prevalence of any contact with mental health professionals and nonuse of mental health care or prescription medications owing to cost among adults with significant psychological distress.

Methods: In samples drawn from the National Health Interview Survey of 1997-2002, multiple logistic regression analysis was used to examine the association of survey year with mental health professional contacts and nonuse of mental health care or prescription medications owing to cost.

Results: The prevalence of any contact with mental health professionals increased from 29.1% in 1997 to 35.5% in 2002 (P<.05). The prevalence of nonuse of services because of cost also increased-from 15.6% to 20.0% for mental health care (P<.05) and from 27.7% to 34.1% for medication use (P<.001). Age, racial/ethnic, income, and insurance status disparities in receiving care persisted over the study period.

Conclusions: The number of individuals in need of mental health care who contacted mental health professionals grew in recent years, as did the number of individuals who encountered cost barriers to such care. Barring dramatic improvements in health insurance coverage, more individuals will likely face such barriers in coming years.

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References

Rogler L . Methodological sources of cultural insensitivity in mental health research. Am Psychol. 1999; 54(6):424-33. DOI: 10.1037//0003-066x.54.6.424. View

Cypres A, Landsberg G, Spellmann M . The impact of managed care on community mental health outpatient services in New York State. Adm Policy Ment Health. 1997; 24(6):509-21. DOI: 10.1007/BF02042829. View

Olfson M, Marcus S, Druss B, Elinson L, Tanielian T, Pincus H . National trends in the outpatient treatment of depression. JAMA. 2002; 287(2):203-9. DOI: 10.1001/jama.287.2.203. View

Kessler R, Barker P, Colpe L, Epstein J, Gfroerer J, Hiripi E . Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003; 60(2):184-9. DOI: 10.1001/archpsyc.60.2.184. View

Strunk B, Cunningham P . Treading water: Americans' access to needed medical care, 1997-2001. Track Rep. 2003; (1):1-6. View

Zuvekas S . Trends in mental health services use and spending, 1987-1996. Health Aff (Millwood). 2001; 20(2):214-24. DOI: 10.1377/hlthaff.20.2.214. View

Endicott J, Spitzer R, Fleiss J, Cohen J . The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry. 1976; 33(6):766-71. DOI: 10.1001/archpsyc.1976.01770060086012. View

Hanley J, McNeil B . The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982; 143(1):29-36. DOI: 10.1148/radiology.143.1.7063747. View

Berk M, Schur C . Measuring access to care: improving information for policymakers. Health Aff (Millwood). 1998; 17(1):180-6. DOI: 10.1377/hlthaff.17.1.180. View

10.

Pauly M . The new Medicare drug benefit: much ado about little?. LDI Issue Brief. 2004; 9(4):1-6. View

11.

Levit K, Smith C, Cowan C, Sensenig A, Catlin A . Health spending rebound continues in 2002. Health Aff (Millwood). 2004; 23(1):147-59. DOI: 10.1377/hlthaff.23.1.147. View

12.

Greenberg D . Congress glumly moves towards Medicare drug benefit: but the cost is expected to be very high, and coverage limited. Lancet. 2003; 361(9376):2216. DOI: 10.1016/s0140-6736(03)13797-x. View

13.

Rabinowitz J, Gross R, Feldman D . Correlates of a perceived need for mental health assistance and differences between those who do and do not seek help. Soc Psychiatry Psychiatr Epidemiol. 1999; 34(3):141-6. DOI: 10.1007/s001270050125. View

14.

Metz C . Basic principles of ROC analysis. Semin Nucl Med. 1978; 8(4):283-98. DOI: 10.1016/s0001-2998(78)80014-2. View

15.

Barnes P, Adams P, Schiller J . Summary health statistics for the U.S. population: National Health Interview Survey, 2001. Vital Health Stat 10. 2005; (217):1-82. View

16.

Alegria M, Canino G, Rios R, Vera M, Calderon J, Rusch D . Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Psychiatr Serv. 2002; 53(12):1547-55. DOI: 10.1176/appi.ps.53.12.1547. View

17.

Appelbaum P . The 'quiet' crisis in mental health services. Health Aff (Millwood). 2003; 22(5):110-6. DOI: 10.1377/hlthaff.22.5.110. View

18.

Mojtabai R, Olfson M, Mechanic D . Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry. 2002; 59(1):77-84. DOI: 10.1001/archpsyc.59.1.77. View

19.

Kessler R, Berglund P, Demler O, Jin R, Koretz D, Merikangas K . The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003; 289(23):3095-105. DOI: 10.1001/jama.289.23.3095. View

20.

Kessler R, Andrews G, Colpe L, Hiripi E, Mroczek D, Normand S . Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002; 32(6):959-76. DOI: 10.1017/s0033291702006074. View