Study Shows 25% of Americans Lack Access to Therapy

Sage Preston
Published Jan 3, 2024


On July 8, results from a survey conducted in December 2020 by the United States Census Bureau indicated that one in four American adults who have anxiety or depression don't have access to the mental healthcare they need in order to treat their conditions. The study also demonstrated that young adults may be affected by anxiety and depression caused by the COVID-19 pandemic for a long time. Mental health has played out to be a critical health issue in light of the pandemic.
 

About the Study


The study results from the Census Bureau were published in the journal Psychiatric Services on July 8. The study reviewed data from the Household Pulse Survey. It was conducted in December 2020 by the Census Bureau and several other federal agencies. The survey included responses from 70,000 people. People were asked if at any time in the past four weeks they needed counseling or therapy services provided by a mental health professional, but they were not able to get it for any reason. The symptoms of anxiety and depression were assessed according to standardized, widely accepted scales. The survey also collected information on education, age and household employment status since March 2020. Income data was also collected. About 18% of the respondents had household incomes less than the federal poverty level. About 50% of respondents reported that a member of their household lost their job some time during the pandemic. Around 61% of the surveyed individuals reported that they had more than a high school diploma for their educational level.
 

Survey Results


Lead author Dr. Jason Nagata, who is also an assistant professor at the University of California at San Francisco, stated that social isolation, anxiety related to the pandemic, disrupted daily routines, loss of employment and food uncertainty caused mental illnesses to surge during the pandemic. About 40% of the adults surveyed said they had symptoms of anxiety or depression during the pandemic. A total of 12.8% of the individuals surveyed said they had a need for mental health therapy or counseling that wasn't met. That's twice as high as the estimates from years before the pandemic. Of all the adults who either met the threshold for anxiety or depression, 25% of them said they didn't have any mental health support.
 

Who Was Most Affected By Lack of Access to Care


Like many other natural and man-made disasters, those who have experienced the worst effects are those who were already living on the economic, social and health margins. Women disproportionately bore the burdens of providing care to the elderly and children during the pandemic when day programs, childcare and schools closed. Young adults had high rates of job loss and experienced more trauma from the social isolation than other groups experienced. The survey results showed that people who were younger, poorer, had a higher education, had a job loss or were female were at a higher risk of not getting the counseling or other type of mental health
 

What the Study Results Mean


These survey results show that the United States has a huge, unmet need for mental health services. Doctors, social workers and psychologists need to take forward-thinking actions to screen for the symptoms of depression and anxiety in their patients. Nurses, nurse practitioners and others in the healthcare setting should also screen people for these conditions. Identifying the condition is the first step in getting a person connected to care. These results also suggest that telepsychiatry or telemental health counseling could improve access to care. For example, a person who lives in a small town where there aren't any psychologists, counselors or psychiatrists could do telehealth with a provider in a metro area in their state. With telehealth, the patient wouldn't have to drive anywhere. This would reduce costs and enhance convenience for the patient. It's important to note that if a person needs medication for their symptoms, they will need to go for an in-person visit to be assessed and for dose checkups. However, for routine counseling, talk therapy can be done through telehealth with great success.
 

Other Barriers to Accessing Mental Healthcare


Many patients have had months-long waiting lists to get connected with a mental healthcare provider. Legislators need to take action to expand telehealth. They also need to add funding for mental health as part of pandemic relief funding. Insurance companies also need to cover telehealth services.

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