ACCESS MENTAL HEALTH SERVICES

Access Mental Health Services

Critically Evaluate The Factors That Influence How People Access Mental Health Services

Access to Primary Care and Mental Health Services

Nationwide, physical examinations were available to clients in 80% of units, but routine medical care in only 61% of units (Table 1). Tuberculosis screening and treatment were available in 58% and 24% of units, respectively. HIV/AIDS treatment was offered in only 21% of units. Only a majority of all clients received services. For example, although mental health services were available in 87% of units, only 24% of clients received these services. However, comparing data from the 1990 wave of this study with these 1995 results D'Aunno and Vaughn 1995 and McCaughrin 1991, the percentage of clients who received physical examinations rose from 33% to 43% and routine medical care went from 25% to 30%, while the percentage of clients who received mental health care remained near the 1990 level of 25%. Over 5.5 million Americans have substance use problems severe enough to warrant treatment, at a cost to society of over 70 billion dollars (Gerstein & Harwood, 1990). Substance-abusing individuals suffer not only from the direct health consequences of substance use, such as cocaine-induced myocardial infarction, but also from multiple related physical and mental health problems including HIV/AIDS, tuberculosis, sexually transmitted diseases and depression (Cherubin & Sapira, 1993; HIV/Linkage Branch, Center for Substance Abuse Treatment, 1992; O'Connor, Molde, Henry, Schockcor, & Schottenfeld, 1992; Stein, Samet, & O'Connor, 1993). Despite great need, substance-abusing persons have difficulty receiving health care Fullilove, Fullilove, Bowser, & Gross 1990, Haverkos & Lange 1990, Pickens & Fletcher 1991, Selwyn et al. 1993, Stein 1990 and Umbricht-Schneiter et al. 1994. Better access to care could reduce their high rates of emergency department visits, hospitalizations, and high-risk behavior, while improving their poor health status (HIV/Linkage Branch, Center for Substance Abuse Treatment, 1992; Stein, O'Sullivan, Ellis, Perrin, & Wartenberg 1993 and Ryan & White 1996). In this regard, addictions treatment units can facilitate the delivery of primary care and mental health services to this underserved, difficult-to-reach population Pickens & Fletcher 1991, Selwyn et al. 1993 and Umbricht-Schneiter et al. 1994. Taken together with evidence that addressing medical and psychosocial problems improves clients' treatment outcomes, it is clear that primary care and mental health services are important components of quality substance abuse treatment Joe, Simpson, & Hubbard 1991, Joe et al. 1992, McCaughrin and Price 1992, McLellan et al. 1994, McLellan, Arndt, Metzger, Woody, & O'Brien 1993, McLellan, Grissom, Brill, Durell, Metzger, & O'Brien 1993, McLellan et al. 1983, Rounsaville et al. 1986 and Woody et al. 1983.

Nonetheless, despite their increasing needs, drug abuse treatment clients' access to health care may be worsening. For example, during the 1980s, the percentage of drug abuse treatment clients who reported unmet psychological needs increased from 20 to 54% in methadone programs, and from 7 to 57% in outpatient drug-free programs (Etheridge, Craddock, Dunteman & Hubbard, 1995). Meanwhile, the percentage of clients who received mental health services declined from 16% ...