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    Social Determinants of Mental Health: Healthcare Access and Quality

    Access to quality healthcare is a critical factor in preventing and managing mental health disorders. Disparities in healthcare access disproportionately affect marginalized communities, leading to untreated or under-treated psychiatric conditions.1,2 Barriers such as lack of insurance, lack of transportation, and healthcare provider bias worsen these outcomes.1

    Clinical Relevance

    • Individuals in areas with limited access to healthcare facilities face delays in diagnosis and treatment, leading to exacerbated psychiatric symptoms.3
    • Lack of parity in reimbursement for mental healthcare is a social determinant of mental health.4
    • Low-income households experience poorer access to care than high-income households across 71% of access measures.2
    • Improved access to care reduces the severity and duration of mental health conditions.

    Economic Impact

    Lack of access to healthcare is a significant economic burden, as individuals may seek emergency care or be hospitalized due to untreated mental health issues, resulting in higher costs for the healthcare system.1,5

    Policy and Programs

    • The Affordable Care Act (ACA) expands access to mental health services for many Americans.
    • Expanding Medicaid and ensuring universal healthcare coverage are critical policy steps to improving healthcare access for marginalized groups.6

    Avenues of Intervention

    • For Psychiatrists: Advocate for expanded healthcare access and ensure that all patients, regardless of insurance status, have access to necessary psychiatric care.7
    • For Individuals: Utilize telemedicine services to bridge the gap in healthcare access, especially for underserved populations.8
    • For Organizations: Push for policy changes that reduce healthcare disparities and expand access to mental healthcare.9

    References

    1. American Psychiatric Association. (2022). Report of the Presidential Task Force on the Social Determinants of Mental Health (.pdf). In American Psychiatric Association.
    2. Agency for Healthcare Research and Quality. (2021). Access to Healthcare and Disparities in Access. In www.ncbi.nlm.nih.gov. Agency for Healthcare Research and Quality (US). https://www.ncbi.nlm.nih.gov/books/NBK578537/
    3. Smith, T. E., Corbeil, T., Wall, M. M., Tang, F., Essock, S. M., Frimpong, E., Goldman, M. L., Mascayano, F., Radigan, M., Wang, R., Rodgers, I., Dixon, L. B., Olfson, M., & Lewis-Fernández, R. (2023). Community, Hospital, and Patient Factors Contributing to Ethnoracial Disparities in Follow-Up After Psychiatric Hospitalization. Psychiatric Services, 74(7), 684–694. https://doi.org/10.1176/appi.ps.20220110
    4. Jeste, D. V., & Pender, V. B. (2022). Social Determinants of Mental Health: Recommendations for Research, Training, Practice, and Policy. JAMA psychiatry, 79(4), 283–284. https://doi.org/10.1001/jamapsychiatry.2021.4385
    5. Marrone, J., & Swarbrick, M. A. (2020). Long-Term Unemployment: A Social Determinant Underaddressed Within Community Behavioral Health Programs. Psychiatric Services, 71(7), 745–748. https://doi.org/10.1176/appi.ps.201900522
    6. Moran, M. (2022). Symposium to Address Social Determinants of Mental Health. Psychiatric News, 57(3). https://doi.org/10.1176/appi.pn.2022.03.3.24
    7. Ehntholt, A., Frimpong, E. Y., Compton, M. T., Rowan, G. A., Ferdousi, W., Swetnam, H., Chaudhry, S., Radigan, M., Smith, T. E., & Rotter, M. (2022). Prevalence and Correlates of Four Social Determinants in a Statewide Survey of Licensed Mental Health Services. Psychiatric Services, 73(11), 1282–1285. https://doi.org/10.1176/appi.ps.202100380
    8. Smith, T. E., Corbeil, T., Wall, M. M., Tang, F., Essock, S. M., Frimpong, E., Goldman, M. L., Mascayano, F., Radigan, M., Wang, R., Rodgers, I., Dixon, L. B., Olfson, M., & Lewis-Fernández, R. (2023). Community, Hospital, and Patient Factors Contributing to Ethnoracial Disparities in Follow-Up After Psychiatric Hospitalization. Psychiatric Services, 74(7), 684–694. https://doi.org/10.1176/appi.ps.20220110
    9. Richmond, L. M. (2022). Need to Address Social Determinants of Health Also an Economic Imperative. Psychiatric News, 57(7). https://doi.org/10.1176/appi.pn.2022.07.7.50

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