Barriers to Mental Healthcare Access

Published May 22, 2022

It is estimated that 1 in 5 (around 40 million) Americans have experienced a mental health issue in their lifetime, 1 in 10 young adults have experienced major depression, and 1 in 25 Americans live with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. Despite the increasing amount of people who experience mental health disorders, the same obstacles barring people’s access to mental healthcare remain. More than half of adults living with a mental illness do not receive the healthcare that they need. In developed countries, the treatment gap ranges from 44% to 70%, while the treatment gap in developing countries is as high as 90%. Recognizing what these obstacles are may allow for much-needed change to begin.

Financial obstacles

The cost of treatment limits access to mental healthcare services. There are millions of individuals with a lack of financial resources that may never seek help at all. Other individuals may have some access to mental health services, but those services can often be found to lead to inconsistent and inadequate treatment. The cost of psychiatric treatment and medication is often unaffordable, and there are fewer in-network options for patients.

Additionally, psychological disorders are not covered by insurance policies in many countries, either. The WHO even reports that 25% of all countries do not provide disability benefits to patients with mental disorders, while one-third of the world’s population lives in countries that allocate less than 1% of their health budget to mental health.

Whether in a developed nation like the U.S. or in a developing nation across the globe, individuals with mental health disorders often find themselves lacking proper treatment and struggling due to their financial situation (and the impossibly high cost that many nations have deemed appropriate for mental health services).

Lack of available mental health professionals and medication

The unavailability of life-saving and everyday medicines in developing countries restricts access to treatment for millions of people around the world. The World Health Organization (WHO) reports that at least 20% of countries do not have at least one common antidepressant, one antipsychotic, and one antiepileptic medication available. Additionally, there is a severe lack of mental health care professionals like psychiatrists and nurses in low-income and middle-income countries.

In the U.S., there is a shortage of qualified mental health professionals to meet our ever-growing demand. The nation is currently staring down a significant clinician shortage, and the mental health specialty is not immune to this. Studies show that there are mental health professional shortage areas in every state across the United States, which creates a significant barrier for patients to access mental health services and care. Due to the shortage, at least 31% of patients could not access healthcare for over a week, causing irreversible damage to patients in crisis.

Ignorance regarding mental health disorders

In both developing and developed countries, ignorance regarding mental illness can prevent people from recognizing mental illness and seeking treatment. A total of 72% of survey respondents report not seeking treatment because they wanted to “solve the problem on their own”, showing that a lack of education regarding mental illness and the need for consistent treatment is a significant barrier to mental healthcare.

Along with ignorance, there is still a persistent amount of negative stigma regarding mental illness and individuals who seek care for their mental illness. This stigma often stems from ignorance on the topic of mental illness and mental healthcare. Individuals have been found to “attempt to distance themselves from the labels that mark them for social exclusion” and have refused to receive care due to the negative stigma that they would be forced to endure from others. Social stigma also obstructs societal awareness about mental health, thus making it more difficult to navigate the mental healthcare industry.

What can we do?

Reducing stigma and increased education: The WHO listed stigma and discrimination towards mentally ill individuals as “the single most important barrier to overcome in the community.” One thing we can do is increase mental illness awareness and continue to educate everyone in our communities about what mental illness is and how people with mental illness need to be viewed in a more favorable light than the ignorance and stigma provide them with.

Task shifting: Physician assistants (PAs) that have specialized training in the mental health field could help improve access to mental health services. Shifting the care of “uncomplicated” patients to PAs, while working under the supervision of psychiatrists, could help the few psychiatrists that are available allocate their time towards patients with serious mental illnesses that need more of their help.

Integration with primary care: To increase access to mental health care, primary care doctors can begin to flag patients for further evaluation by psychiatric PAs and other mental health professionals. These mental health professionals can screen more patients, implement straightforward first-line treatments, and maintain consultation and referral options to psychiatrists embedded in primary care offices. This means that mental health should be integrated with primary care and physical health because treating both health issues as separate conditions makes it both more confusing and more expensive for patients. Integration is key.

Technology-based tools: Using video calls to attend mental health visits can resolve problems associated with the lack of mental health practitioners. There are also software-based tools that can give standard cognitive-behavioral therapy, which has been proven to be as effective as in-person therapy.

Conclusion

Understanding and acknowledging what barriers exist to prevent mental healthcare access allows us as a society to improve that access with more efficient mental healthcare programs, treatment, and policies.

 

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