Trends in Contacts With Mental Health Professionals and Cost Barriers to Mental Health Care Among Adults With Significant Psychological Distress in the United States: 1997–2002

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Abstract
Objectives. I assessed recent trends in prevalence of any contact with mental health professionals and nonuse of mental health care or prescription medications owing to cost among adults with significant psychological distress. Methods. In samples drawn from the National Health Interview Survey of 1997–2002, multiple logistic regression analysis was used to examine the association of survey year with mental health professional contacts and nonuse of mental health care or prescription medications owing to cost. Results. The prevalence of any contact with mental health professionals increased from 29.1% in 1997 to 35.5% in 2002 (P<.05). The prevalence of nonuse of services because of cost also increased—from 15.6% to 20.0% for mental health care (P<.05) and from 27.7% to 34.1% for medication use (P<.001). Age, racial/ethnic, income, and insurance status disparities in receiving care persisted over the study period. Conclusions. The number of individuals in need of mental health care who contacted mental health professionals grew in recent years, as did the number of individuals who encountered cost barriers to such care. Barring dramatic improvements in health insurance coverage, more individuals will likely face such barriers in coming years.