title: Comparing barriers to mental health treatment and substance use disorder treatment among individuals with comorbid major depression and substance use disorders.
abstract: Barriers to both mental health and substance use disorder treatments have rarely been examined among individuals with comorbid mental health and substance use disorders. In a sample of 393 adults with 12-month major depressive episodes and substance use disorders, we compared perceived barriers to these two types of treatments. Data were drawn from the 2005-2011 U.S. National Surveys on Drug Use and Health. Overall, the same individuals experienced different barriers to mental health treatment versus substance use disorder treatment. Concerns about negative views of the community, effects on job, and inconvenience of services were more commonly reported as reasons for not receiving substance use disorder treatment. Not affording the cost of care was the most common barrier to both types of treatments, but more commonly reported as a barrier to mental health treatment. Improved financial access through the Affordable Care Act and parity legislation and integration of mental health and substance use disorder services may help to reduce treatment barriers among individuals with comorbid mental health and substance disorders.
authors.affiliation: Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, MD. Electronic address: rmojtaba@jhsph.edu.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Chen
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Kaufmann
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Crum
mesh_terms: D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder / Q000150:complications / Q000191:economics / Q000628:therapy*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000150:complications / Q000191:economics / Q000534:rehabilitation*; D014481:United States; D055815:Young Adult
keywords: Barriers to care; Comorbidity; Mental health services; Service use; Substance disorder services