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Study Finds ‘Mismatch’ of Mental Health Need, Care

At the same time, the proportion of people with little or no distress nonetheless receiving mental health care rose from 17 percent to 21 percent.

Prescriptions for antidepressants and other psychiatric drugs also are increasing, from 50 percent to 64 percent among those with serious distress, and 15 to 19 percent for those with little or no distress, according to the report.

But fewer than 5 percent of the tens of thousands of people surveyed had serious distress. That means those who are in real need account for a significantly smaller portion of the overall increase in mental health care, the researchers said.

The findings were published online recently in the journal JAMA Psychiatry.

These results jibe with research going back decades with the American health care system, said Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University.

Much of the U.S. market for mental health care is cash-based, involving people seeking self-improvement, self-understanding or the means to cope with minor anxieties, Humphreys said.

“A lot of it comes out of people just buying it themselves, like they might have an exercise coach or something,” he added. “That’s fine, but those problems are nothing compared to having schizophrenia and being on a street corner shivering and thinking the CIA is chasing you. We’ve always had much more trouble getting that much more severe group what they need.”

But Olfson said there are reasons beyond money why distressed people aren’t getting the care they need.

The stigma against seeking mental health care might dissuade people from reaching out, he suggested. Their disorder also might get in the way of seeking help; for example, a depressed person might be so demoralized that he or she feels therapy wouldn’t benefit them.

The United States is also contending with an ongoing shortage of mental health professionals, Olfson pointed out.

“There are lots of places in the United States, particularly in rural and remote regions, where there are very few mental health providers,” Olfson said.

The current situation might be somewhat better than shown in this study. Humphreys noted that the last survey period ended in 2015, just as the Affordable Care Act began drastically expanding insurance coverage in the United States.

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