What Are the Barriers to Accessing Mental Health Care in Massachusetts? Study Describes Wait Times, Impediments

Mental health disorders affect more than a million adults in Massachusetts, according to the 2014 National Survey on Drug Use and Health.

But from 2010 to 2014, an average of 46 percent of adults aged 18 and older with any mental illness in Massachusetts did not receive treatment. Also, several state reports have documented barriers to accessing mental health services and anecdotes of long wait times for outpatient mental health appointments in Massachusetts.

However, limited information exists on the accessibility of mental health services in Massachusetts. Policy makers lack publicly available data measuring actual wait times in the Commonwealth, and few studies report on the factors contributing to wait times for outpatient mental health services.

Abt Global, on behalf of the Blue Cross Blue Shield of Massachusetts Foundation, conducted a comprehensive mixed-methods study to:

• Quantify the wait times for outpatient mental health office visits in Massachusetts;
• Better understand the experiences of clients seeking an appointment; and
• Identify facilitators or barriers to accessing mental health services.

The study, entitled “Access to Outpatient Mental Health Services in Massachusetts,” collected primary data from multiple sources, including 21 interviews with stakeholders and four focus groups with clients seeking outpatient mental health services in Massachusetts. Researchers gathered quantitative data from a representative survey of mental health clinicians who provide outpatient mental health services in Massachusetts and a survey of administrators at organizations that provide outpatient mental health services to predominantly MassHealth clients.

The study’s findings include:

• Individuals and stakeholders describe the process of connecting with an outpatient mental health provider as complicated and onerous;
• Clients experienced long wait times from the point at which they identified a need for outpatient mental health services. Wait times for psychiatrists were longer than those for other types of licensed mental health providers;
• Wait times for a provider with particular expertise in caring for a child or adolescent are longer than those for an adult provider. The wait time for a child psychiatry appointment, in particular, is typically even longer than for other mental health providers with expertise in caring for a child or adolescent; and
• Stakeholders report that providers’ selective insurance acceptance means that individuals who are able to self-pay can access care more quickly than those who must rely on insurance. Providers report that they are most likely to accept commercial insurance and least likely to accept public insurance – Medicare and Medicaid. A substantial portion of providers report not accepting any insurance at all.

Read more about the study.