CW: Mental Health
According to a study conducted by Weill Cornell Medicine researchers, many Medicaid beneficiaries who require psychiatric care have trouble getting care in a timely manner. There is also a greater demand for psychiatric care among this demographic.
The study, published on July 31 in The Journal of the American Medical Association, discovered that few psychiatrists and other mental health professionals who are listed as accepting new Medicaid patients are actually reachable and have appointments available. Wait times for appointments could occasionally reach six months. The study was led by Dr. Diksha Brahmbhatt, M.D. ’24, a resident physician at Brigham and Women’s Hospital, and senior author William Schpero, an assistant professor of population health sciences.
The researchers conducted a study, calling randomly chosen psychiatric professionals(psychiatrists, nurse practitioners, and physician assistants) from Medicaid managed care provider directories in New York City, Los Angeles, Chicago, and Phoenix. The researchers requested the earliest available appointment for depression treatment with the selected provider If that provider was unavailable, an alternate provider was sought.
Only 18% of the sampled providers in the four cities were reachable, accepted Medicaid, and offered an appointment. They were all labeled as in-network for Medicaid.
While New York City had the highest appointment availability (36% of offices contacted provided an appointment with the sampled doctor or an alternate), the median wait time was 28 days. On the opposite end of the scale, only 15% of calls for appointments in Los Angeles were successful, with a typical wait period of 64 days.
Of the 263 doctors who could not be reached, 15% had erroneous or out-of-service phone numbers, and 35% did not answer the phone on either of two calls. Though this study did not compare appointment availability for Medicaid patients versus commercial insurance, other studies have found that Medicaid beneficiaries have less access to psychiatric care than those with private insurance.
The Cornell University study highlights an ongoing shortage of mental health professionals throughout the country. Since the beginning of the COVID-19 pandemic , the prevalence of mental health issues, such as anxiety and depression, has tripled. Anxiety and depression are affecting approximately one-third of U.S. adults.
However, the mental health workforce has not grown to meet the rising need. In May 2023, around 163 million Americans lived in areas with a shortage of mental health professionals. The shortage is disproportionately affecting communities whose members frequently are low-income and are members of racial-ethnic minority groups.
According to a 2023 KFF study, White adults (50%) are more likely to report receiving mental health care in the last three years than Black (39%) and Hispanic persons (36%). In addition, across racial and ethnic groups, about half of all adults (53%) who reported receiving mental health care rated them as very or extremely helpful. Asian and Black adults who received or attempted to receive mental health care were more likely to have difficulty locating a clinician who understood their history and experiences than their White counterparts.
All people should have access to mental health care. Insurance shouldn’t be a barrier to receiving the mental health care that you need. People should also have access to culturally appropriate services.
Sources:
Brahmbhatt, Diksha, and William L. Schpero. “Access to Psychiatric Appointments for Medicaid Enrollees in 4 Large US Cities.” JAMA 332.8 (2024).
Belz, Franz F., et al. Lessons From Low- and Middle-Income Countries: Alleviating the Behavioral Health Workforce Shortage in the United States. Psychiatric Services, Https://psychiatryonline.org/doi/full/10.1176/appi.ps.20230348, vol. 75, no. 7, American Psychiatric Publishing, July 2024, pp. 699–702, doi:10.1176/appi.ps.20230348. July 01, 2024.
Goldman, Howard H. “How Phantom Networks And Other Barriers Impede Progress On Mental Health Insurance Reform..” Health affairs (Project Hope) 41.7 (2022): 1023-1025.
Hill, Latoya, et al. “Racial and Ethnic Disparities in Mental Health Care: Findings from the KFF Survey of Racism, Discrimination and Health.” KFF, KFF , 23 May 2024, http://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-and-ethnic-disparities-in-mental-health-care-findings-from-the-kff-survey-of-racism-discrimination-and-health/.