Medical debt fuels mental health treatment gap
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As many as 1 in 4 U.S. adults with depression and anxiety can't pay their medical bills — a situation that could be limiting their ability to get timely psychiatric care, Johns Hopkins researchers found.
Why it matters: Fewer than half of all U.S. adults with mental disorders receive treatment, and the findings show those with common behavioral disorders face high out-of-pocket costs because many psychiatrists don't participate in insurance networks.
What they found: Medical debt was linked with more than a twofold increase in delayed or forgone treatment for mental disorders among more than 27,600 adults surveyed, the researchers wrote in JAMA Psychiatry.
- 19.4% to 27.3% reported they had medical debt over the past year.
- Insured people with high deductibles were likelier to be affected than uninsured people, who may already be forgoing treatment.
- Efforts to relieve some of the debt burden could actually worsen mental health, if the assistance is insufficient and winds up amplifying a patient's feelings of distress.
Between the lines: Medical debt is a growing societal problem that's particularly squeezing middle-income Americans and has been linked to bad health outcomes and food and housing insecurity, regardless of insurance status or income.
- About 1 in 12 U.S. adults have unpaid medical bills of at least $250, with people in the South and rural areas reporting the greatest burden, the Peterson Center on Healthcare and KFF found earlier this year.
- The issue is becoming fodder for the the presidential campaign, with President Biden touting his administration's efforts to keep medical liabilities off credit reports.
The JAMA Psychiatry study didn't differentiate between those who had depression or anxiety before incurring medical debt and those whose debt may have precipitated or exacerbated anxiety and mood disorders.
- Researchers also said they were limited in capturing racial and ethnic disparities in mental disorders and mental health service use.
