Using data from the 2006-2014 National Health Interview Survey conducted by the Centers for Disease Control and Prevention, Judith Weissman, Ph.D., J.D., and colleagues from New York University School of Medicine examined 11 indicators of access, utilization, and function among 207,853 adults. Among the indicators were presence or absence of health insurance coverage, insufficient money for health care and/or medications, delay in health care, insufficient money for health care, visiting a doctor 10 or more times in the past 12 months, limitations in ability to work, limitations in activities of daily living, insufficient money for mental health care, and having seen a mental health care provider.
The researchers found that adults with SPD were significantly more likely than those without SPD to experience barriers to care—including no health coverage, delays in care, lack of money to buy medications and to pay for mental health care services, and change in usual place of health care because of insurance. Although a lack of health coverage and money to buy medications worsened for all adults between 2008 and 2011, the study revealed that the proportion of adults with SPD who lacked money to buy medications continued to climb into 2014.
At the same time, the study found that adults with SPD were more likely than those without SPD to visit a doctor 10 or more times in the past 12 months.
“It is paradoxical that although SPD is associated with several indicators of poor utilization and access, as well as relatively poor general medical health, it is also associated with high utilization of expensive outpatient care,” the authors wrote. “[E]mbedding mental health care providers within the primary care setting and embedding PCPs within the mental health setting … may facilitate better treatment of both mental health and general medical conditions. Moreover, integration of care may reduce chaotic health care utilization, including frequent changes in the location of health care.”
For related information, see the Psychiatric Services article “Characteristics of Individuals With Behavioral Health Conditions Who Remain Uninsured After Full Implementation of the ACA.”