Employer-covered workers with mental health conditions face access barriers
People who had a mental health condition receiving health coverage through an employer are twice as likely to report difficulty obtaining necessary care, according to a new survey of more than 3,100 U.S. workers.
Among those polled this spring by the Employee Benefit Research Institute (EBRI), 27% said they or someone on their health plan had a mental health condition.
Those who reported a mental health condition for themselves or another on their plan were more often between the ages of 25 and 54, married or living with a partner and worked for an employer with fewer than 1,000 staff. Anxiety, depression and attention-deficit/hyperactivity disorder were the conditions most frequently reported by respondents.
Thirty-one percent of the respondents with a mental health condition among their plan members said they weren’t able to get necessary care, tests or treatment for themselves from a physician within the past six months, as opposed to 15% of those who did not report mental health conditions among plan members, according to the survey.
The differences between the two groups were most stark among those who specified being unable to get mental health or behavioral health care (33% versus 13%) and a prescription for a mental health or behavioral health need (32% versus 14%).
The EBRI underscored that smaller portion of respondents who said they didn’t have a mental health condition among plan members but still sought out mental health or behavioral services, which the group said “is consistent with the well-documented underreporting of mental health conditions.”
As for why the respondents weren’t able to receive care, surveyed workers reporting a mental health condition much more often said their doctor had refused to accept their insurance (32% versus 17%) and also cited issues taking time off work or finding child care (27% versus 18%). Issues with a health plan that wouldn’t approve, cover or pay for care was often cited by those with a mental health condition (52%) as well as those without (46%).
The EBRI also found that workers with a mental health condition among plan members much less often said they hadn’t sought care at an emergency room within the past half year and were twice as likely and four times as likely to report visiting three times and four times, respectively. Such behaviors raise concerns of an unmanaged condition and greater healthcare spending at the individual and system levels.
“U.S. workers know this already, and the survey brings it home: even with insurance from an employer, getting mental healthcare is much too hard,” Anna Bobb, executive director of the Path Forward Coalition, a mental healthcare access advocacy group that coordinated with the EBRI on the survey report, said in a statement. “We need to make care available early for mental health conditions, just like we do for other common chronic conditions. The ER shouldn’t be frontline treatment for mental illness any more than it should be frontline treatment for heart disease.”
The EBRI and the Path Forward Coalition, in a release, said the survey’s findings align with other recent data from the National Alliance on Mental Illness, which found about half of workers understand how to access mental healthcare through their employer-sponsored insurance plan. The groups also said they found respondents reporting mental health conditions were more likely to say they’d compared prices, researched clinician quality and discussed treatment options with their providers.
“That suggests problems getting mental healthcare aren’t due to lack of trying,” the groups said.