• Posted September 20, 2023

Few Doctors, Spotty Internet: Finding Mental Health Care Tough for Many Americans

Nearly one in five counties across the United States lack psychiatrists or internet service, making it difficult for around 10.5 million Americans to find mental health care, a new study shows.

The counties examined in the study were more likely to be in rural areas, have higher unemployment rates, and have populations that were more likely to be uninsured and lack a bachelor's degree. What's worse, individuals who fall into any one of these categories are also more likely to suffer from depression and anxiety. So, the need for mental health services is especially critical in areas with the greatest barriers to access, the researchers noted.

And while the pandemic created a rapid demand for telehealth, the medium has yet to reach the areas that need it most.

"Telehealth was originally developed to mitigate the adverse effects of physician shortage. But unfortunately for many people in shortage areas, they don't have access to broadband coverage,"said study author Dr. Hao Yu, an associate professor of health care policy at Harvard Medical School, in Boston.

"We found those counties have negative health effects, like higher overdose mortality, higher suicide mortality. That's kind of staggering,"he added.

In July, the Bipartisan Infrastructure Law was passed by federal legislators and included a $65 billion investment to expand affordable and reliable high-speed internet access across the United States. While this is a good start, Yu said the U.S. government should focus specifically on the counties covered in the study.

"What we studied is tied to another priority of the current administration. That is, to reduce drug overdose mortality and to reduce suicide rates. Given our findings, those counties are really the true target of the current investment,"he said.

The study was published online Sept. 14 in JAMA Network Open.

Through the American Rescue Act, the Biden administration also allotted $330 million in funding to train more physicians in high-need areas. The Consolidated Appropriations Act of 2021 also worked to increase care in minority communities.

But while holes in access still exist, said Dr. Victor Fornari, head of child and adolescent psychiatry at Long Island Jewish Medical Center in Glen Oaks, N.Y., telehealth is still an effective stopgap.

"Access to health care, and mental health care in particular, continues to be a major challenge for a variety of reasons: location, transportation, insurance coverage, adequate resources and just simply access to technology,"he said. "So providing access to health care means having access to the technology to support telehealth, whether it be through smartphones, laptops, or wi-fi and cell service."

Yu said he hopes future studies will examine whether government investments will actually improve access to mental health in high-need regions.

In April, Surgeon General Vivek Murthy called mental health issues among young people "the defining public health crisis of our time,"issuing an advisory about the negative effects social media has on adolescents.

And there are plenty of staggering figures for American adults, too. One in eight is on antidepressants, according to the U.S. Centers for Disease Control and Prevention, while one in five has recently received some kind of mental health care. Almost one-third report symptoms of anxiety and depression, while roughly one in 25 has a serious mental illness. Three million American adults suffer or have suffered from opioid use disorder, and one in two are very lonely.

Perhaps the most chilling statistic of all: Suicide rates have risen by about 30% for many vulnerable groups since the turn of the millennium, according to the KFF.

For people who are suffering, connecting with others, practicing gratitude, taking care of physical health, and meditation are some useful tactics for improving mental health.

More information

For more on mental health, visit Mental Health America.

SOURCES: Hao Yu, PhD, associate professor of health care policy, department of population medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston; Victor Fornari, MD, chief, child and adolescent psychiatry, Long Island Jewish Medical Center, Glen Oaks, N.Y., and professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, N.Y.; JAMA Network Open, Sept. 14, 2023, online