The Distribution of US Adult Mental Health Patients Across Provider Groups

Abstract

Abstract Objective To describe the distribution of US adult mental health outpatients across provider groups. Methods We examined a nationally representative sample of US adults from the 2018–2021 Medical Expenditure Panel Surveys. We classified psychological distress using the Kessler-6, and by acute mental healthcare episode (inpatient or emergency department) in the survey year. We report outpatient mental health use rates, visit share by provider group (counselors, social workers, psychologists, psychiatrists, nurse practitioners/physician associates, primary care physicians, other physicians, and other) and by service sector including mental health, medical, both, or neither. Results Of adults with ≥ 1 outpatient mental health visit, 58.2% (95%CI 56.4–60.0%) received mental health visits in the mental health sector alone, 24.3% (95%CI 22.8–25.7%) were seen in the medical sector alone, and 15.2% (95%CI 14.1-16.25%) were seen in both. The largest differences in mental health care were seen for patients who had recent acute mental healthcare episodes who were more likely to receive care in both medical and mental health sectors, 35.5% (95%CI 29.1–41.9) versus 14.5% (95%CI 13.4–15.5%) among those who did not have acute mental healthcare episodes. Of the 8 provider groups, only psychiatrists were more likely to have seen patients with higher than lower levels of distress. Conclusion Adult mental health patients with episodes of acute mental healthcare were more likely than those without to have received mental health visits in both mental health and medical sectors. Among the provider groups, only psychiatrists saw a greater share of patients with higher than lower levels of psychological distress.