Increasing mental health treatment access and equity through trauma-responsive care.

2021 ◽  
Author(s):  
Joshua P. Mersky ◽  
James Topitzes ◽  
Jeffrey Langlieb ◽  
Kenneth A. Dodge
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Treatment Access ◽  
Health Treatment ◽  
Access And Equity

scholarly journals Structural Correlates of Mental Health Support Access Among Sexual Minority Youth of Color During COVID-19

2021 ◽  
Author(s):  
Chantelle A Roulston ◽  
Sarah McKetta ◽  
Maggi Price ◽  
Kathryn Fox ◽  
Jessica L. Schleider
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Mental Healthcare ◽  
State Level ◽  
Structural Factors ◽  
Marginalized Youth ◽  
Treatment Access ◽  
Health Treatment ◽  
Mental Health Support ◽  
Health Support

Objective: Many youth with mental health needs cannot access treatment, with multiply-marginalized youth, such as sexual minority youth of Color (SMYoC), experiencing both structural and identity-related barriers to care. The COVID-19 pandemic threatens to exacerbate multi-level treatment access barriers facing SMYoC youth nationwide. However, little large-scale research has examined access to mental health care among SMYoC across the United States, either during or prior to the pandemic. Such work is critical to understanding and ameliorating barriers in this domain. Methods: Using data from adolescents who self-identified as SMYoC and who endorsed a desire for mental health support during the COVID-19 pandemic (N=470, ages 13-16, from 43 U.S. states), we examined associations between state-level, structural factors (income inequality; mental healthcare provider shortage; anti-Black racism; homophobia; and the interaction between anti-Black racism and homophobia) and SMYoC mental health treatment access. Results: Multinomial logistic regressions revealed state-level mental healthcare provider shortage as the only significant predictor of SMYoC reporting they never (versus always) accessed mental health support during the COVID-19 pandemic. SMYoC living in areas with both lower homophobia and lower anti-Black racism were more likely to report always (versus sometimes) accessing mental health treatment. Conclusions: Results highlight the critical importance of considering diverse structural factors and applying an intersectional lens when exploring barriers to mental health treatment among multiply-marginalized youth. In locations where provider shortages are less severe, cultural stigma—including anti-Black racism and homophobia—may still pose challenges for SMYoC in need of mental health care.

scholarly journals Can Mobile Health Improve Depression Treatment Access and Adherence Among Rural Indian Women? A Qualitative Study

2018 ◽  
Author(s):  
Amritha Bhat ◽  
Ramakrishna Goud ◽  
Johnson Pradeep ◽  
Geetha Jayaram ◽  
Rajiv Radhakrishnan ◽  
...  
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Mobile Health ◽  
Mental Health Treatment ◽  
South India ◽  
Depression Treatment ◽  
Treatment Access ◽  
Health Treatment ◽  
Barriers To Access ◽  
Mobile Mental Health

Introduction: Low rates of follow up with mental health treatments, and medication non-adherence are common among patients with Major Depressive Disorder (MDD), more so in low-middle income countries (LMIC). While mobile mental health has the potential to address this problem in resource-poor settings, the feasibility and acceptability of its use in rural women is unknown. We aimed to explore barriers to access and adherence to mental health treatment, and the feasibility of using mobile health to address these barriers among women with MDD in rural south India. Methods: Six focus groups were conducted among women with MDD (n=69) seeking care at a rural community health center in South India. Discussion centered on barriers to mental health treatment access and adherence and attitudes toward use of technology in addressing these barriers. We transcribed the discussions and analyzed them using qualitative analysis software. Results: Reasons for non-adherence were: transcultural explanatory model of illness; structural, financial and social barriers to access, and medication side-effects. Women were unenthusiastic about mobile health solutions due to illiteracy, lack of family support, unfamiliarity with use of mobile devices, lack of access to mobile phones and preference for in-person clinical consultation. Conclusions: This qualitative study examines the acceptability of mobile-mental health as a strategy to address barriers to depression treatment access and adherence among women in a rural setting. There are several barriers to adoption of mobile mental health technology in LMIC. It is important to address these barriers before implementing mobile health based solutions.

scholarly journals Predicting mental health treatment access in high-symptom adolescents: Machine learning approaches

2019 ◽  
Author(s):  
Mallory Dobias ◽  
Michael Brandon Sugarman ◽  
Michael C Mullarkey ◽  
Jessica L. Schleider
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Mental Health Treatment ◽  
The United States ◽  
Depression Symptoms ◽  
Treatment Access ◽  
Health Treatment ◽  
Adolescent Treatment ◽  
Out Of Sample ◽  
Mental Health Treatments

Objective: A majority of adolescents experiencing depression never access treatment. To increase access to effective mental health care, it is critical to understand factors associated with increased versus decreased odds of adolescent treatment access. This study investigated the relative importance of individual depression symptoms and sociodemographic variables in predicting whether and where adolescents with depression accessed mental health treatments. Method: We performed a pre-registered, secondary analysis of data from the 2017 National Survey of Drug Use and Health (NSDUH), a nationally representative sample of non-institutionalized civilians in the United States. Using four cross-validated random forest models, we predicted whether high-symptom adolescents (N = 1,671; ages 12-17 years) accessed specific mental health treatments in the previous 12 months (“yes/no” for inpatient, outpatient, school, any). Results: 53.38% of adolescents with elevated depressive symptoms accessed treatment of any kind. Even with depressive symptoms and sociodemographic factors included as predictors, pre-registered random forests explained < 0.00% of pseudo out-of-sample deviance in adolescent access to inpatient, outpatient, school, or overall treatments. Exploratory elastic net models explained 0.80 - 2.50% of pseudo out-of-sample deviance in adolescent treatment access across all four treatment types. Conclusions: Neither individual depressive symptoms nor any socioeconomic variables meaningfully predicted specific or overall mental health treatment access in high-symptom adolescents. This study highlights substantial limitations in our capacity to predict whether and where high-symptom adolescents access mental health treatment and underscores the broader need for more accessible, scalable adolescent depression treatments.

Mental Health Treatment Access and Quality in the Army

2014 ◽  
Vol 20 (6) ◽  
pp. 448-459 ◽  
Author(s):  
JOYCE C. WEST ◽  
JOSHUA E. WILK ◽  
FARIFTEH F. DUFFY ◽  
S. JANET KURAMOTO ◽  
DONALD S. RAE ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Treatment Access ◽  
Health Treatment ◽  
Access And Quality

scholarly journals Pediatric Primary Care Provider Comfort with Mental Health Practices: A Needs Assessment of Regions with Shortages of Treatment Access

2021 ◽  
Author(s):  
Amie F. Bettencourt ◽  
Rebecca A. Ferro ◽  
Jami-Lin L. Williams ◽  
Kainat N. Khan ◽  
Rheanna E. Platt ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Treatment ◽  
Pairwise Comparisons ◽  
Health Practices ◽  
Treatment Access ◽  
Health Treatment ◽  
Friedman's Test ◽  
Mental Health Practices ◽  
Post Hoc

Abstract Objectives Nearly 50% of children with a mental health concern do not receive treatment. Child Psychiatry Access Programs like Behavioral Health Integration in Pediatric Primary Care (BHIPP) address regional shortages of mental health treatment access by providing training and consultation to primary care providers (PCPs) in managing mental health concerns. This study assessed PCPs’ comfort with mental health practices to inform expansion of BHIPP services. Methods Pediatric PCPs in 114 practices in three rural regions of Maryland were recruited to participate in a survey about their comfort with mental health practices and access to mental health providers for referral. Descriptives, Friedman’s test, and post hoc pairwise comparisons were used to examine survey responses. Results Participants were 107 PCPs. Most respondents were physicians (53.3%) or nurse practitioners/physician’s assistants (39.3%). Friedman’s test, χ2(7)= 210.15, p<.001, revealed significant within and between-group differences in PCP comfort with mental health practices. Post hoc pairwise comparisons indicated greater comfort providing mental health screening and referrals compared to prescribing psychiatric medications, providing psychoeducation or in-office mental health interventions. A Wilcoxon-signed rank test showed significantly more respondents agreed they could find a therapist than a psychiatrist in a timely manner, Z= −5.93, p<.001. Conclusions Pediatric PCPs were more comfortable with providing mental health assessment and referrals than treatment. However, PCPs reported difficulty finding therapists and psychiatrists for their patients. Findings underscore the need for longitudinal training to increase PCP comfort with mental health treatment. Additionally, strategies such as telepsychiatry are needed to address the disproportionate need for child psychiatrists.

Sign in / Sign up

Export Citation Format

Share Document