Mental Health Treatment Access: Personal Experience and Public Opinion

• In Event: Health Care Rights and Mental Health Policy in the United States

Abstract

What do Americans think about the state of mental health treatment in the United States? Even before the COVID-19 pandemic, which is thought to have triggered a spike in mental health problems around the world, roughly one in five American adults experienced a mental illness, and a steadily increasing proportion of adults reported serious thoughts of suicide. At the same time, the American health care system is poorly equipped to provide treatment for those in need – fewer than half of adults with a mental illness received treatment (again, before the pandemic), and roughly one third of Americans live in a designated Mental Health Care Professional Shortage Area. Even those who can find a provider may not be able to afford the care they need, either because they are uninsured or because their insurance plan does not provide adequate coverage for mental health care, despite federal regulations on mental health parity and essential health benefits. There is, then, a compelling case for government to do more to improve access to mental health care, both in terms of bolstering the mental health workforce (especially in shortage areas) and more aggressively regulating plans to ensure adequate coverage of needed services. But do Americans see it this way? Will policymakers find it politically rewarding to undertake such efforts? In this project, I use new data from a nationally representative 1000-respondent module on the 2022 Cooperative Election Study (CES) that includes questions about the respondent’s own experiences in seeking mental health care, the barriers they encountered in doing so, and their perspective on what government should do to address the problem. Questions include whether the respondent had trouble finding a provider that would accept them, if they had trouble affording treatment, if they felt uncomfortable seeking treatment, and if their insurance plan failed to provide adequate coverage. Respondents who have never sought such treatment were presented with similar issues framed as hypotheticals for a “person like them” seeking treatment. This will allow me to contrast firsthand experience with the impressions of those who may not have thought much about this issue before, while geographic identifiers will allow for a comparison of both with local statistics on access to care. I hypothesize that personal experience in seeking treatment, especially when a person faced significant difficulties in doing so, will lead to increased support for public action on mental health treatment access. If this prediction is born out, ongoing increases in the incidence of mental health problems and the difficulty of finding treatment may serve to increase public pressure in favor of policy solutions. Secondarily, thanks to the CES Common Content, this project will also shed light on the political and demographic correlates of mental health treatment takeup, difficulty in accessing treatment, and mental health policy views.

Author

• Jake Haselswerdt, University of Missouri, Columbia