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AJPH First Look, published online ahead of print Sep 29, 2005
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American Journal of Public Health, 10.2105/AJPH.2003.037630

Research and Practice

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

Ramin Mojtabai 1*

1 Columbia University

* To whom correspondence should be addressed. E-mail: rm322{at}columbia.edu.


  Abstract

ABSTRACT Objectives: To assess recent trends in contacts with mental health professionals and cost barriers to mental health care among adults in need of such care. Methods: Data from the National Health Interview Survey (NHIS) of 1997 to 2002 were analyzed. Each year, NHIS drew representative cross-sectional samples from the household US population. Among adults with significant psychological distress, ascertained by the K6 instrument, trends in contacts with mental health professionals in the past year and forgone use of mental health care or prescription medications due to cost were examined across years. Results: Among individuals in need of mental health care, the prevalence of any contact with mental health professionals increased across years from 29.1% in 1997 to 35.5% in 2002 (P<0.05). Prevalence of forgone mental health care and forgone medication use due to cost also increased between 1997 and 2002--from 15.6% to 20.0% for mental health care (P<0.05) and from 27.7% to 34.1% for medication use (P<0.001). Age, racial/ethnic, income and insurance disparities in receiving care from mental health professionals and cost barriers persisted over time. 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 experienced cost barriers to such care. Barring dramatic improvements in health insurance coverage, it is likely that the number of individuals who will face such barriers in coming years will continue to increase.

Key Words: Insurance, Access to Care, Mental Health, Surveys




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