In the decade between 2004-2005 and 2014-2015, the percentage of American adults accessing outpatient mental health treatment increased, according to study results published in JAMA Psychiatry. However, most of this increase was driven by increased treatment of adults without serious psychological distress.
Many adults with serious mental illness continue to be untreated, whereas a substantial percentage of mental health services are provided to individuals with lower levels of distress. Thus, there is concern that mental health services may be misallocated.
Using Medical Expenditure Panel Survey (MEPS) data, Mark Olfson, MD, MPH, of the New York State Psychiatric Institute, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, and colleagues analyzed recent trends in the use of outpatient mental health services by adults in the United States. Use of services was then stratified by the degree of psychological distress to evaluate how adults with varying degrees of distress have reacted to changes in mental health treatment patterns.
MEPS data showed that of 139,862 adult participants, the percentage using outpatient mental health services increased from 19.08% in 2004-2005 to 23.00% in 2014-2015. Although most of the increase could be attributed to participants without serious psychological distress, more than two-thirds of participants with serious psychological distress used outpatient mental health services between 2014 and 2015, an increase of 14.3% from 2004 to 2005. During the same time period there was a decline in serious psychological distress from 4.82% to 3.71%.
The investigators suggested that this might be attributable in part to better acceptance of treatment for mental illness, as well as better access to mental health care through Medicaid and the Affordable Care Act. Nonetheless, many adults with serious mental distress still fail to receive mental health care. The investigators noted that improvements in detecting and treating or referring patients with serious mental illness are needed.
Olfson M, Wang S, Wall M, Marcus SC, Blanco C. Trends in serious psychological distress and outpatient mental health care of US adults [published online November 28, 2018]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2018.3550