Individuals With Mental Illness Continue to Face Barriers in Access to Care: Michael McGuire, PharmD

One in 4 adults with frequent mental distress were not able to see a mental health care practitioner due to costs, Mental Health America stated in their most recent report on the state of mental health in America.1

Mental Health America is a nonprofit organization dedicated to promoting mental health, well-being, and illness prevention. In addition to the cost barrier in mental health services access, the report also stated that 10% of adults and 8.5% of youth have private insurance that does not cover mental health treatment or services.1 Michael McGuire, PharmD, a pharmacology professor at Belmont University, reviewed the report but was not surprised by what the data revealed.

“We frequently encounter limitations in being able to get [medications] approved for patients,” McGuire said in an interview with The American Journal of Managed Care®. “Say the one that we think is best for the patient is not covered by their insurance plan. [The insurance] may have one available, but the one they have available is not the one that we feel like is best for the patient.”

The report also ranked states on the prevalence of mental illness based on data that included the number of adults with any mental illness (AMI) and adults with serious thoughts of suicide or substance abuse disorder, etc. Overall, the three lowest-ranked states were Montana (49), Arizona (50), and Nevada (51), which also had the highest percentage of youth with at least one major depressive episode and serious thoughts of suicide. The 3 highest-ranked states were Maine (3), Connecticut (2), and Massachusetts (1), which had some of the lowest percentages of youth with private insurance that did not cover mental or emotional problems and adults reporting 14 or more mentally unhealthy days a month but could not see a doctor due to costs.

Furthermore, the report also noted that in 2022, rural counties had the highest percentage of adults with AMI at 25.7% when compared with large metropolitan counties at 22.1%. Housing also posed a significant deterrent to individuals with mental illness. On average, both prolonged and intermittent exposure were associated with lower mental health (Beta = −1.338 [95% CI, 2.178-0.488]) and (Beta = −0.516 [95% CI, −0.868 to 0.164], respectively).2

“If you don't have stable housing, you can't consistently get in for treatment,” McGuire said. “So, if you can get people with these disorders stably housed, then they can get consistently treated. But if they're not stably housed, treatment is extremely difficult.”

References

1. Reinert, M, Fritze, D, & Nguyen, T (July 2024). “The state of mental health in America 2024.” Mental Health America, Alexandria, VA.

2. Baker, E., Lester, L., Mason, K., et al. Mental health and prolonged exposure to unaffordable housing: a longitudinal analysis. Soc Psychiatry Psychiatr Epidemiol. 2020;55(6):715-721. doi:10.1007/s00127-020-01849-1. doi: 10.1007/s00127-020-01849-1