Who Gets Needed Mental Health Care? Use of Mental Health Services among Adults with Mental Health Need in California.

Background: Timely and appropriate treatment could help reduce the burden of mental illness.

Purpose: This study describes mental health services use among Californians with mental health need, highlights underserved populations, and discusses policy opportunities.

Methods: Four years of California Health Interview Survey data (2011, 2012, 2013, 2014) were pooled and weighted to the 2013 population to estimate mental health need and unmet need (n=82,706). Adults with mental health need had "unmet need" if they did not use prescription medication and did not have at least four or more mental health visits in the past year. Multivariable logistic regression analysis was performed to predict the probability adults with mental health need did not receive past-year treatment (n=5,315).

Results: Seventy-seven percent of Californians with mental health need received no or inadequate mental health treatment in 2013. Men, Latinos, Asians, young people, older adults, people with less education, uninsured adults, and individuals with limited English proficiency were significantly more likely to have unmet need. Cost of treatment and mental health stigma were common reasons for lack of care.

Conclusion: Unmet mental health need is predominant in California. Policy recommendations include continued expansion of mental health coverage, early identification, and ensuring that treatment is culturally and linguistically appropriate.