title: Are barriers to mental health and substance abuse care still rising?
abstract: This study estimates unmet need and barriers to alcohol, drug, and mental health (ADM) services in 1997 to 1998 using data from a national household survey (n = 9,585). In 1997 to 1998, 10.9% of the population perceived a need for ADM services, with 15% obtaining no treatment and 11% experiencing delays or obtaining less care than needed. The rate of unmet need due to no treatment is similar to earlier studies, but the group experiencing delays/less care is almost as large. This finding emphasizes the importance of defining access to care more broadly by including timeliness and intensity of care. Economic barriers are highest for the uninsured, but also are high among the privately insured. Individuals with unmet need are significantly more likely to use complementary and alternative medicine (CAM). Those with no conventional mental health care rely on self-administered treatment, while those with delayed/insufficient conventional care use CAM providers and self-administered treatment.
authors.affiliation: RAND, 1700 Main Street, Santa Monica, CA 90407-2138, USA. Roland_Sturm@rand.org
authors.forename: R
authors.initials: R
authors.lastname: Sturm
authors.forename: C D
authors.initials: CD
authors.lastname: Sherbourne
mesh_terms: D000529:Complementary Therapies / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D008605:Mental Health Services / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012494:Sampling Studies; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D014481:United States