Individuals with depression and/or anxiety are more than twice as likely to carry medical debt that makes paying bills difficult compared with individuals without those diagnoses, according to a report in JAMA Psychiatry. In addition, those with depression or anxiety who carry medical debt are more likely to delay or forego treatment than diagnosed individuals without medical debt.
Kyle J. Moon, B.S., of Johns Hopkins Bloomberg School of Public Health, and colleagues noted that financial barriers are the most prominent barrier to mental health care among low-income adults in the United States. “When bills are unpaid, the outstanding amount is sent to debt collections, with personal debt limiting access to credit and hindering subsequent use of health care services,” they wrote.
The researchers examined data from 27,651 adults who responded to the 2022 National Health Interview Survey. They looked at associations between medical debt and delayed or foregone care among four subgroups—those with lifetime depression, current depression, lifetime anxiety, current anxiety—and individuals without a history of those diagnoses.
A total of 5,186 adults (18.2%) reported lifetime depression, 1,948 (7.3%) reported current depression, 4,834 (17.7%) reported lifetime anxiety, and 1,689 (6.6%) reported current anxiety.
Medical debt was significantly more common among individuals with a lifetime or current diagnosis of depression or anxiety. Differences were more pronounced for those with a current diagnosis: 27.3% of adults with current depression had medical debt, compared with 9.4% of adults without, while 26.2% of adults with current anxiety had medical debt, compared with 9.6% of adults without.
Among adults with current depression or anxiety, 36.9% and 38.4%, respectively, of those with medical debt delayed getting counseling or therapy from a mental health professional within the past year due to the cost, compared with 17.4% and 16.9%, respectively, of those without medical debt. Likewise, adults with current depression or anxiety and medical debt were more than twice as likely as those without debt to forego needed therapy due to cost.
“Medical debt appears to contribute to the mental health treatment gap, suggesting that aggressive debt collection practices have negative consequences for population mental health,” Moon and colleagues wrote. “Further studies are needed to evaluate policies to inform protections against medical debt at the federal level.”
For related information, see the Psychiatric Services article “Debt Inequity Among Clients of a Community Mental Health Center.”
(Image: Getty Images/iStock/KLH49)
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