Primary Submission Category: Health care/services
Trends in treatment provision for mental Illness and substance use in the United States from 1997 through 2024
Authors: Marilyn Sinkewicz, Clarke Philippa, Iris Gomez-Lopez,
Presenting Author: Marilyn Sinkewicz*
Economic and health shocks, such as the COVID-19 pandemic and the opioid crisis, have intensified concerns about the mental health of adults and children in the United States. Recently, the Surgeon General declared a public mental health emergency. In the decades-long struggle to support various populations, mental health and substance use (MHSU) treatment provision has been guided by limited evidence, e.g. research on specialty services by psychiatrists, select geographic areas, specific user groups, and discrete time periods. To improve planning, policy, and programs, this study uses national longitudinal neighborhood-level data from a wide range of public sources to examine the evolving nuances of MHSU treatment provision from 1997 through 2024. We analyze these novel data and produce heat maps and geospatial hot spot maps to show overall patterns and trends, as well as particular dynamics by source of treatment, demography, and geography. Initial findings reveal that MHSU treatment is delivered by a wide variety of providers and facilities, and that the overall density of treatment provision increases over time. However, the distribution of treatment provision is uneven at the turn of the 21th century, and differences widen over the next 24 years. For example, the density is higher and growth is faster for non-specialty treatment provision (primary care physicians, non-physician providers, and support centers) than for specialty treatment (psychiatrists, and psychiatric hospitals and non-hospital facilities). Also, source-specific trends differ with respect to their trajectories, geographic impact, and demographic groups affected: urban neighborhoods widen their advantage over rural areas; economically affluent neighborhoods improve more than disadvantaged ones; and white neighborhoods progress more than black and Hispanic neighborhoods. By contrast, psychiatric hospitals become concentrated in rural areas, particularly disadvantaged rural and black rural areas.