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Primary care doctors struggle to find mental health services for patients

Inadequate insurance coverage and health plan barriers are among reasons making referrals difficult.

By Damon Adams — Posted April 30, 2009

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Two in three primary care physicians were unable to get outpatient mental health services for their patients, according to a study published online April 14 by Health Affairs.

That 67% figure is about twice the rate of doctors who were unable to get other specialist referrals or imaging services for patients.

More than half of the surveyed doctors cited the following reasons for not being able to get mental health care for patients: lack of or inadequate insurance coverage, health plan barriers and shortages of mental health professionals.

"From the perspective of primary care physicians, the study findings suggest that lack of access to mental health services is a serious problem -- much more serious than for other commonly used medical services," according to a statement by study author Peter J. Cunningham, PhD, a senior fellow at the Center for Studying Health System Change, a nonpartisan policy research organization in Washington, D.C.

The study was based on findings from the center's 2004-05 Community Tracking Study Physician Survey of a nationally representative sample of about 6,600 physicians, including 2,900 primary care physicians. The survey asked doctors if they had trouble getting outpatient mental health services and referrals to other specialists, among other things.

Data were obtained before passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. The measure mandated mental health parity in private insurance benefits nationwide. Before the legislation, state mental health parity laws had only a small impact on reducing disparities in mental health access, according to the study. More details are online (link).

The study said that even with the national parity act, large gaps in mental health access will remain, and the measure will not resolve severe access problems of the uninsured or the shortage of mental health care professionals.

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