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West JC, Clarke DE, Duffy FF, et al. Availability of Mental Health Services Prior to Health Care Reform Insurance Expansions. Psychiatr Serv. 2016;67(9):983-9doi: 10.1176/appi.ps.201500423.
West, J. C., Clarke, D. E., Duffy, F. F., Barber, K. D., Mojtabai, R., Mościcki, E. K., Kroeger Ptakowski, K., & Levin, S. (2016). Availability of Mental Health Services Prior to Health Care Reform Insurance Expansions. Psychiatric services (Washington, D.C.), 67(9), 983-9. https://doi.org/10.1176/appi.ps.201500423
West, Joyce C, et al. "Availability of Mental Health Services Prior to Health Care Reform Insurance Expansions." Psychiatric services (Washington, D.C.) vol. 67,9 (2016): 983-9. doi: https://doi.org/10.1176/appi.ps.201500423
West JC, Clarke DE, Duffy FF, Barber KD, Mojtabai R, Mościcki EK, Kroeger Ptakowski K, Levin S. Availability of Mental Health Services Prior to Health Care Reform Insurance Expansions. Psychiatr Serv. 2016 Sep 01;67(9):983-9. doi: 10.1176/appi.ps.201500423. Epub 2016 Apr 15. PMID: 27079993.
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Psychiatr Serv. 2016 Sep 01;67(9):983-9. doi: 10.1176/appi.ps.201500423. Epub 2016 Apr 15.

Availability of Mental Health Services Prior to Health Care Reform Insurance Expansions.

Psychiatric services (Washington, D.C.)

Joyce C West, Diana E Clarke, Farifteh Firoozmand Duffy, Keila D Barber, Ramin Mojtabai, Eve K Mościcki, Kristin Kroeger Ptakowski, Saul Levin

Affiliations

  1. Dr. West, Dr. Clarke, Dr. Duffy, Ms. Barber, and Dr. Mo?cicki are with the American Psychiatric Association Foundation, Arlington, Virginia (e-mail: [email protected] ). Dr. Clarke is also with the Division of Research, American Psychiatric Association, Arlington, Virginia. Dr. Mojtabai is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Ms. Kroeger Ptakowski and Dr. Levin are with the American Psychiatric Association, Arlington, Virginia.

PMID: 27079993 DOI: 10.1176/appi.ps.201500423

Abstract

OBJECTIVES: This study sought to examine psychiatrists' perceptions of gaps in the availability of mental health and substance use services and their ability to spend sufficient time and provide enough visits to meet patients' clinical needs.

METHODS: A cross-sectional probability survey of U.S. psychiatrists was fielded during September through December 2013 by using practice-based research methods, including distribution by priority mail. Psychiatrists (N=2,800) were randomly selected from the American Medical Association Physician Masterfile, and 1,188 of the 2,615 (45%) with deliverable addresses responded. Of those, 93% (N=1,099) reported currently treating psychiatric patients, forming the sample for this study.

RESULTS: Thirty percent or more of psychiatrists reported being unable to provide or find a source for each of the following services in the past 30 days: psychotherapy, housing, supported employment, case management or assertive community treatment, and substance use treatment. Approximately 20% reported being unable to provide or find a source for inpatient treatment, psychosocial rehabilitation, general medical care, pharmacologic treatment, and child and adolescent treatment. Approximately half (52%) of psychiatrists reported not having enough time during patient visits, affecting 28% of patients. More than one-third (37%) reported being unable to provide enough visits to meet patients' clinical needs, affecting 24% of patients.

CONCLUSIONS: Psychiatrists reported constrained availability of a range of mental health, substance use, and general medical services. In order for the Affordable Care Act to realize the promise of increased access to care, the infrastructure for mental health and substance use treatment, workforce, and services delivery may require significant enhancement.

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