Research Paper on "Access to Mental Health Treatment"

Research Paper 5 pages (1638 words) Sources: 3

[EXCERPT] . . . .

Obstruct Access to Mental Health Treatment

Mental health problems are common enough, and many people experience isolated bouts of depression or anxiety from time to time, but these problems typically dissipate and never create long-term problems. For some people, though, mental health problems can cause harmful, life-altering consequences if left untreated. Unfortunately, if the reports are to be believed, there are a lot of mentally ill people walking around in the United States who never receive professional treatment for their condition in their entire lifetimes. Indeed, some authorities argue that as many as nine out of ten people who need mental health treatment do not receive these services as the result of a wide range of factors that obstruct access, and these factors are particularly prevalent among minorities. To gain some current insights into the factors that obstruct access to mental health treatment, this paper provides a review of the relevant literature, followed by a summary of the research and important findings in the conclusion.

Review and Discussion

Background and Overview

The United States has a mixed mental health care delivery system comprised of a partnership between the public and private sector that draws on evidence-based practices to treat the entire constellation of mental health conditions. Currently, though, access to mental health services is described by authorities as being dismal at best and a "national failure" at worst. For instance, Conyne emphasizes that, "Only 10% of children and adults who need mental health services receive them from mental health specialists or general medical providers in any given year. This disconnect between the need for mental health services and their delivery is a national failure" (2004, p. 11).

One of the more troubling aspects of this major disconnect between what is needed and what is being delivered is just how inequitable access is for whites compared to minorities. In this regard, Conyne adds that, "Even worse, access to mental health services is more limited for ethnic and racial minority members. In fact, striking disparities exist between access to mental health services for whites and for minorities" (2004, p. 11).

There have been four major areas of inequities identified with respect to whites and minorities and the provision of mental health services in the United States in recent years:

1. Minorities have less access to and availability of mental health services;

2. Minorities are less likely to receive the mental health services they need;

3. Minorities often receive poorer quality treatment; and,

4. Minorities are underrepresented in mental health research.

It is clear that there are some profound inequities in the provision of mental health care services to ethnic and racial minority members, but Conyne (2004) suggests that the increased access is an across-the-board problem, but there are some initial steps that must be taken to facilitate long-term change. In this regard, Conyne writes, "Although all of these disparities are alarming, the first two are most immediately pertinent with regard to prevention. The high need for mental service is not matched with its provision or with access to it" (2004, p 11).

Obstacles to Access to Mental Health Services

Although the specific factors that obstruct access to mental health services will vary from individual to individual, there are a number of general factors that have been identified that can obstruct access to mental health services in the United States, including the following:

1. Mental health care is expensive.

2. Services are too frequently fragmented.

3. Many Americans do not have health insurance and, if they do, the mental health coverage may be inadequate or cumbersome to arrange and maintain.

4. Services may not be located within reach for many who need them.

5. For many, a stigma is attached to being involved with mental health services and so they avoid using these services (Conyne, 2004).

Taken together, there are several factors that individually or in combination can adversely affect access to mental health services, particularly the multidisciplinary individualized type of treatments that many people require. In this regard, Conyne concludes that, "In sum, the overall supply of mental health professionals is not sufficient to meet the overall demand, especially if mental health services are delivered remedially to one individual at a time" (2004, p. 11). These are especially salient observations with respect to the racial, cross-cultural and age-specific mental health treatments that are required. While there has been growing interest in identifying efficacious treatments for mental health disorders among children and adolescents, there has not been a corresponding increase in the amount of research directed at the specific obstacles to access to mental health services that exist among young people with mental health disorders. For instance, according to Ollendick and March (2004), "Recent advances in our ability to identify and treat childhood anxiety disorders effectively, as well as our understanding of the morbidity associated with untreated anxiety disorders, highlight the importance of improving children's access to treatment" (2004, p. 530). Indeed, barriers to access to mental health services can have profound and long-term consequences for young people. In this regard, Brindis, Morreale and English (2003) emphasize that, "High rates of suicide, depression, and substance abuse in adolescents suggest that many teens need access to mental health and substance-abuse services" (p. 116). Given this profound need, it is troubling that so many obstacles to access to mental health services continue to prevent many young people from receiving the help they need to regain control over their lives. In fact, Brindis and her associates point out that, "Although the possibility of broad coverage for mental health and substance-abuse services [exists], numerous limitations exist, such as high cost sharing and restrictions on numbers of outpatient visits per year, numbers of inpatient days permitted, and the types of providers who can deliver services and be reimbursed" (2003, p. 117). For example, "although the foregoing obstacles are typically applicable to younger children and adults, their implications for adolescents are even more severe. As Brindis et al. stress, "[Obstacles to access] are likely to have greater significance for adolescents: During this developmental period, many behaviors and illnesses that require mental health services-such as drug use, depression, and eating disorders -- have their onset" (2003, p. 117).

While many young people remain at a disadvantage because of these obstacles to access to mental health services, racial and ethnic minorities are faced with some other, even more complex barriers as well. For instance, Weine, Kulauzovic, Klebic et al. (2008) report that, "Because refugees have high rates of mental health problems, providing refugee mental health services is a recognized U.S. national priority. Many, though not all, communities of resettlement offer specialized mental health services for refugees" (p. 150). Despite their availability, there are some significant cultural factors involved in the provision of mental health services that can discourage or even prevent ethnic minorities from seeking out mental health care. In this regard, Weine and his colleagues emphasize that, "Even when mental health services are available, many refugees who suffer do not use them. Mental health services theory suggests other possible explanations for access difficulties, including those related to family members' attitudes (e.g., stigma), information (e.g., lack of knowledge about treatments and their benefits), and trust (e.g., lack of connection with persons who can vouch for the appropriateness of services" (2008, p. 150). In some cases, family-based mental health services are needed for these minority members, but Weine et al. caution that, "It can be difficult to get youth and families to join and attend multiple-family groups. Special steps need to be taken to promote engagement and retention" (2008, p. 151).

On a final note, a growing number of healthcare providers are making the argument that eliminating obstacles to access to mental health services just makes good economic sense (Gauthier, 2004). In this regard, Allen-Kelly and Charikar (2010) report that,… READ MORE

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