Survey: More Than Half Of Mass. Adults Struggle Finding Help With Mental, Substance Abuse Problems

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Many of us know from experience: It's much harder to get an appointment for mental health or substance use care than for most physical illnesses.

A survey of 2,201 adults from the Blue Cross Blue Shield Foundation of Massachusetts confirms the experience with some stark numbers.

It found that more than half of Massachusetts adults who tried finding help for mental health or substance abuse problems said they had difficulty finding anyone who would see them. More than one-third gave up seeking help entirely, and about 1 in 8 went to the emergency room for treatment.

In an interview with WBUR's Bob Oakes on Morning Edition (click on the player at the top left of the story to listen), foundation President Audrey Shelto said these types of difficulties strike lower-income people the hardest. While many are on MassHealth, the state's version of Medicaid, about 45 percent of mental health/substance use providers don't accept Medicaid reimbursement, she said.

And about 10 percent of providers in the state don't take any insurance at all, she said.

"What they will accept is someone who can come in and write a check for the appointment," she said.

More of the survey's results show what happens when a person can't find help to treat their mental illness or substance abuse disorder: 54 percent of adults said they could not work or participate in their normal activities for some of the past 30 days. Nearly 40 percent went without mental health or substance use care or a prescription. And it's not just about mental health — nearly 60 percent of the respondents who had a hard time getting mental health or substance abuse care struggled to get care for physical ailments as well.

For those 1 in 8 who went to the ER, the cost of care was even higher, said Shelto. And many of those who go to the ER want to seek outpatient treatment elsewhere — but they can't find it.

These results come to a sharp focus on Tuesday as business leaders convene to discuss their goal of cutting health care costs by $100 million in the next two years. Their main strategy is reducing unnecessary visits to hospital emergency rooms.

The survey shows young, white, low-income women are hit especially hard by the gap in needed mental health care. Those struggling to pay for heat, rent and food were the largest group of those seeking treatment this year. Nearly three-quarters earned $36,420 or less, which is 300 percent of the federal poverty level in 2017.


"People end up going without care that they have been seeking," said Shelto, and it takes a toll on them, and their families.

The Baker administration notes that mental providers complain about low reimbursement rates and onerous paperwork requirements from both private insurers and MassHealth. But the survey points out that the Baker-Polito administration is spending more than $1.9 billion on behavioral health care in the current fiscal year to increase payments for pediatric mental health care, addiction treatment and to boost psychiatry services in community health centers.

"I read results from this survey as unfortunately, not surprising, but a real call to action to say we have got to start focusing on the fact that almost a quarter of adults in the commonwealth say they need mental health or substance use disorder services," said Shelto.

The survey comes just under two weeks after the Centers for Disease Control and Prevention said that increasing rates of drug overdose deaths and suicide mean the life expectancy for Americans has dropped for the third year in a row. The rise in what two Princeton economists call "deaths of despair" appears to have deep and tangled roots.

This segment aired on December 11, 2018.

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Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.



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