Record Number of Americans Suffer Serious Mental Distress

By Megan Brooks
WebMD Health News

April 18, 2017

A record 8.3 million US adults, or 3.4% of the US population, suffer from serious psychological distress (SPD), yet many go without proper treatment, according to a new analysis of federal data.

SPD involves feelings of sadness, worthlessness, and restlessness severe enough to impair one's physical well-being. Previous estimates put the number of Americans suffering from SPD at 3% or less.

The investigators analyzed data from the National Health Interview Survey for 2006 to 2014 on a diverse group of more than 207,000 Americans aged 18 to 64 years from more than 35,000 US households.

"Based on our data, we estimate that millions of Americans have a level of emotional functioning that leads to lower quality of life and life expectancy," lead study investigator Judith Weissman, PhD, JD, a research manager in the Department of Medicine at NYU Langone Medical Center, New York City, said in a news release. "Our study may also help explain why the US suicide rate is up to 43,000 people each year."

"And there has been an uptick in the last decade of suicide and serious psychological distress in the middle age. The middle age is a newly discovered high-risk group," she told Medscape Medical News.

The study was published online April 17 in Psychiatric Services.

The analysis also showed that between 2006 and 2014, access to healthcare services deteriorated for people with SPD.

"Although our analysis does not give concrete reasons why mental health services are diminishing, it could be from shortages in professional help, increased costs of care not covered by insurance, the great recession, and other reasons worthy of further investigation," Dr Weissman said in the release.

"One thing that is important to highlight is the impact of the recession of 2008 on the mentally ill," she told Medscape Medical News. "They didn't recover in their ability to utilize healthcare the way that people who were not mentally ill were able to recover. Somehow maybe they were barely holding on before the recession, and then they were wiped out and they still have not recovered."

Chaotic Healthcare Utilization

Dr Weissman noted that the situation seems to have worsened despite the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Affordable Care Act, which include provisions designed to help reduce disparities in insurance coverage for people with mental health problems.

Comparing self-reported SPD symptoms across the 9-year period (2006-2014), the researchers estimate that nearly 1 in 10 Americans (9.5%) with SPD still did not have health insurance in 2014 that would give them access to a psychiatrist or counselor, a slight rise from 2006, when 9% lacked any insurance.

They further estimate that 10.5% of people with SPD in 2014 experienced delays in getting professional help due to insufficient mental health coverage; for 2006, 9.5% said they experienced such delays. In addition, 9.9% could not afford to pay for their psychiatric medications in 2014, up from 8.7% in 2006.

The study also found that adults with SPD were more likely to visit a physician 10 or more times in the past year, relative to those without SPD.

"There is this paradox with the mentally ill in that they do actually see a lot of doctors," Dr Weissman told Medscape Medical News. "They have high utilization, yet at the same time they have very poor health, and they continue to have poor mental health. It's a pattern that appears to be chaotic health care utilization in the mentally ill."

Part of the problem, Dr Weissman said, is that there are not enough mental health care providers. "Even among the mentally ill that have health coverage, trying to find a psychiatrist or mental health provider is hard, so they go to their primary care physician, who is not trained to take care of their mental illness, and their health and mental health suffers."

The study had no commercial funding. The authors have disclosed no relevant financial relationships.

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SOURCE: Medscape, April 18, 2017. Psychiatr Serv. Published online April 17, 2017.

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