A recent survey, funded by the Mental Health Treatment and Research Institute LLC, a tax-exempt subsidiary of The Bowman Family Foundation, has revealed the worsening mental health and substance use crisis. The report's authors urge immediate action to ensure fair access to timely and effective care and adequate reimbursement by insurers. Despite progress in recognizing mental health as a crucial aspect of overall well-being, in-network health insurance coverage for mental health and substance use treatment remains insufficient, falling behind coverage for physical health treatment. To address this critical issue, NORC, a non-partisan research institute at the University of Chicago, conducted a patient-experience survey, providing valuable insights into the challenges faced by patients seeking mental health and substance use care.

There is an immediate and pressing requirement for mental health services

The survey underscores the urgent necessity for accessible mental health and substance use care. Patients nationwide are encountering difficulties in obtaining the treatment they require, encountering obstacles in locating in-network providers who accept new patients. The survey delves into the frequency with which mental health or substance use care is required but not received, drawing attention to the potential consequences of unmet mental health needs.

As patients face difficulties with in-network providers, they frequently resort to seeking care from out-of-network sources. The survey investigates the reasons behind this trend and analyzes the disparities between seeking mental health or substance use care versus physical health care. Understanding these patterns is critical in developing strategies to improve access to in-network care for all.

Patients often rely on primary care providers and other physical health providers for mental health or substance use care. However, the survey reveals concerns about the adequacy of care provided by PCPs and physical health professionals for mental health conditions. Addressing these concerns could lead to more integrated and comprehensive care models.

The survey also examines the prevalence of service denials and disparities faced by patients seeking mental health and substance use care. These challenges not only impede access to treatment but can also exacerbate existing mental health conditions, underscoring the urgent need for policy changes and awareness.

The principal discoveries

The survey findings indicate a notable discrepancy between the provision of mental health care and physical health care, underscoring the pressing necessity for impartial and prompt treatment alternatives.

Restricted Availability of Mental Health and Substance Use Treatment:

According to the survey, a significant proportion of patients seeking mental health or substance use care, specifically 57%, did not receive any care in at least one instance, in contrast to 32% of patients seeking physical health care. The figures were even more concerning for adolescents, with 69% experiencing limited access to mental health and substance use care, compared to only 17% for physical health care. These statistics underscore the urgent need to enhance access to mental health services for patients across all age groups.

Challenges Associated with Locating In-Network Service Providers:

Forty percent of individuals who utilize health insurance and seek care from in-network mental health or substance use providers are required to contact four or more in-network providers before securing an appointment with a new in-network provider. In contrast, only 14% encountered comparable difficulties when seeking physical health care. This underscores the obstacles patients face when attempting to locate suitable and accessible mental health care providers within their insurance network.

Significant dependence on providers outside of the network:

A considerable proportion of patients, particularly those enrolled in employer-sponsored health plans, availed services from mental health or substance use providers who were not part of their network. As much as 39% of patients opted for out-of-network providers for outpatient care, in contrast to a mere 15% for physical health care. The financial strain of elevated co-pays and deductibles borne by patients utilizing out-of-network providers highlights the pressing need to enhance in-network coverage for mental health and substance use care.

The necessity for specialized care is imperative in order to ensure optimal health outcomes:

The significance of integrated care and the pivotal role of specialized professionals in effectively addressing mental health and substance use issues are underscored by the fact that an overwhelming majority of patients, including 87% of all ages and 98% of adolescents, who received mental health or substance use care from physical health providers felt the need for additional assistance from a mental health or substance use specialist.

Effective enhancement of behavioral healthcare necessitates collaboration as a fundamental component:

The NORC patient-experience survey illuminates the significant inequalities in accessing mental health and substance use care in the United States. The results emphasize the urgent requirement for policymakers, insurers, and healthcare providers to work together and implement fair solutions. By enhancing provider networks, improving in-network insurance coverage, and addressing service denials, we can make significant progress in ensuring that mental health and substance use care are equivalent to physical health treatment. Let us work together towards a future where all individuals have access to timely and effective care, resulting in better mental well-being and healthier communities.