Why People Don’t Get Help for Alcohol Use

Alcohol misuse is common – more than 16 million US adults (about seven percent) have alcohol use disorder. Yet many people don’t get help.  Less than one in 10 people with alcohol use disorder receiving treatment, according to the 2013 National Survey on Drug Use and Health.



Many people with alcohol use disorder don’t think they need treatment, yet even among people who believe they need treatment, only 15-30 percent receive treatment.  Researchers looking into why people don’t get treatment found barriers related to beliefs and attitude the biggest obstacle.



Among people who believe they need treatment, their attitudes are the most commonly reported barriers, according to research reported  in Psychiatric Services in Advance on August 3, 2015  Financial barriers (e.g., couldn’t afford it) and structural barriers (e.g., didn’t have time, didn’t know where to go) were cited much less frequently.



The top barriers to seeking help for alcohol problems were

• I should be strong enough to handle it alone -  42%

• The problem would get better by itself - 33%

• Not serious enough to seek treatment  - 21%

• Too embarrassed to discuss it - 19%



Previous research has identified some characteristics that make if more or less likely that people will seek treatment: unmarried people are more likely to get treatment than married people and men are more likely to get treatment than women.



One ongoing problem, the researchers note, is that many doctors are still uncomfortable asking about alcohol use.



Concerned about your own drinking?  See an online assessment from NIAAA and learn more problem drinking and getting help in Rethinking Drinking. Find help with SAMHSA’s Behavioral Health Treatment Locator or 24-hour toll-free Referral Helpline at 1-800-662-HELP (1-800-662-4357).





By Deborah Cohen, Senior Writer, American Psychiatric Association

Diversity, Culture, and Mental Health

Diverse Populations and Mental Health

July is the American Psychiatric Association’s Diversity Mental Health Month, a time to appreciate the diversity among us and to focus on the unique mental health issues of diverse populations and efforts to reduce mental health disparities.  It’s clear we live in an increasingly diverse society, but how does that diversity relate to mental health and receiving quality mental health services?



Cultural background, including race/ethnicity and other aspects, can greatly influence how we think and feel about mental health and illness, how we experience symptoms, how we communicate about mental illness, and how and where we seek help.  Some people may be reluctant to talk about mental health concerns out of fear or shame, some people may seek help from faith leaders, while others may turn to a family doctor or a mental health professional.  (See the infographic from APA:  Mental Health and Diverse Populations.)

Extensive research tells us that ethnic and racial disparities in mental health care exist. A new report from Substance Abuse and Mental Health Services Administration (SAMHSA) notes that among adults with mental illness, whites, American Indian/Alaska Natives, and adults reporting two or more races reported higher mental health service use than black, Asian, and Hispanic adults. (See chart.)

Being aware of differences in the use of mental health services among different ethnic/racial population groups is critical for mental health professionals. That is part of what Diversity Mental Health Month is about – increasing understanding among psychiatrists about the influences of cultural diversity in their practices.



The SAMHSA report also looked at why people don’t use mental health services.  Adults across all racial/ethnic groups cited the same reason most frequently for not using mental health services:  the cost of services cost or lack of insurance.  Other reasons included:  low perceived need; stigma; and structural barriers. Concern about whether mental health services would help was the least cited reason by all racial/ethnic groups.


The top barrier to care, cost, may at least be partly addressed as more people gain access to mental health care with the Affordable Care Act and the Mental Health Parity Act. Many organizations, including the APA, are working to improve cultural sensitivity and to reduce the stigma of mental health, particularly among racial and ethnic minority populations.


By Ranna Parekh, M.D., M.P.H., Director

APA Division of Diversity and Health Equity



This post is part of an ongoing series spotlighting diversity from APA’s Division of Diversity and Health Equity.

Know Your Rights: Fair Insurance Coverage for Mental Health

Federal
law is clear that health insurance companies cannot discriminate against people
seeking care for mental illness or addiction. But how do you know if your insurance
company is not complying with the law? What can you do if you suspect a
violation?

The
American Psychiatric Association (APA) created a tool to help answer these
questions. The poster titled, “Fair Insurance Coverage: It’s the Law”
(Spanish-language version), clearly and
simply explains the law and the steps to take if you suspect a violation.

The
poster is intended to help enforce federal law and end discrimination.  Print it out and share the link (www.psychiatry.org/parity).

By
understanding your rights and taking action you can help ensure fair coverage
for yourself and your family, and you can help others by holding insurance
companies accountable.

What Federal Law Requires

The Mental Health
Parity and Addiction Equity Act requires any group health plan that covers more
than 50 employees and offers mental health and/or substance use disorders
coverage to provide that coverage with no greater financial requirements (such
as co-pays, deductibles, annual or life-time dollar limits) or treatment
limitations than the requirements the plan applies to medical / surgical
benefits. 

Also,
under the Affordable Care Act, new individual and small group plans in and
outside of the mandated health
insurance exchanges are required to offer mental and substance use
disorder coverage similar to medical/surgical benefits.

In addition to federal law, 49 states
and D.C. currently have laws relating to insurance coverage for mental health
and substance use.  More information,
including a summary table of state laws, is available from the National Conference of State Legislators.

By Deborah Cohen, senior writer, American Psychiatric Association