Understanding predictors of mental health and substance use treatment utilization among US adults: A repeated cross-sectional study
Open accessAbstract
Background: Understanding discrepancies in mental health and substance use treatment utilization can help identify inequities in access to health services. We investigate mental health and substance use treatment utilization as function of demographic and social determinants, as well as pre-existing mental health and substance use disorders. Methods: In this repeated cross-sectional study, we used the 2017-2019 National Survey on Drug Use and Health data on US adults above age 18. Two logistic regression models were conducted, using predictors of age, gender, race/Hispanicity, sexual identity, education, insurance, family income, and past year mental health and substance use disorders, with outcomes of mental health or substance use treatment utilization. Weighted estimates of substance use disorders and insurance types and Pearson's correlation tests of vulnerability among age, gender, and treatment type were reported. Findings: Racial minorities, uninsured populations, sexual minorities, and females had lower odds of receiving mental health treatment, while older populations, lower income groups, and dual eligible enrollees had higher odds. Individuals with substance use disorders but no mental illness had higher odds of receiving mental health treatment. Those utilizing mental health treatment were mostly of high income, privately insured, and using cannabis, cocaine, and opioids. Older populations, men, and Medicaid only enrollees had higher odds of receiving substance use disorder treatment, whereas racial minorities had lower odds. Distribution of income, insurance type, and substance use were more widespread than mental health treatment. Interpretation: Mental health treatment can be used as an avenue for substance use treatment, particularly opioid use disorders. It is important to target vulnerable populations, like racial minorities and uninsured populations to improve access to mental health and substance use treatment.
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Co-occurring mental illness and mental health treatment can be used as avenues for substance use treatment.
“Research has also shown that co-occurring mental illness and mental health treatment can be used as avenues for substance use treatment [13,19].”
From Treatment Use Among U.S. Adults with a Substance Use Disorder: Associations with Symptom Severity, Problem Self-Perception, Comorbid Mental Illness, and Mental Health Treatment (2025) · cites this paper as [13]
The Conclusion says mental health services should develop capacity to treat people with substance use disorders, supporting mental health treatment as an avenue for substance use treatment. The Results report higher odds of substance use treatment among adults with a mental illness, but the Discussion says people with co-occurring mental health and substance use disorders were excluded from the analysis. The paper therefore does not establish the claim specifically for co-occurring mental illness. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPrevious research identified personal-level and environmental/structural barriers to SUD treatment receipt.
“Previous research on treatment receipt barriers identified both personal-level and environmental/structural factors.”
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Cites
The Self-Medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications
Khantzian, E. J. (1997) · Harvard Review of Psychiatry · doi:10.3109/10673229709030550 · Cited by 3,242 · cited 1× · see citing works
“Additionally, adults with substance use disorders may believe that their disorder is a product of the need to self-medicate to reduce mental health symptoms [28].”
BackgroundMethamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults
Han, B., Compton, W. M., Jones, C. M., Einstein, E. B., & Volkow, N. D. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.2588 · Cited by 380 · see citing works
Americans' Attitudes Toward Mental Health Treatment Seeking: 1990–2003
Mojtabai, R. (2007) · Psychiatric Services · doi:10.1176/ps.2007.58.5.642 · Cited by 282 · see citing works
Joynt, M., Train, M. K., Robbins, B. W., Halterman, J. S., Caiola, E., & Fortuna, R. J. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-013-2516-z · Cited by 152 · see citing works
Flagged first, then by citations
Research works printed but not linked: 27
- [11]Robertson-Preidler J. Trachsel M. Johnson T. Biller-Andorno N. The affordable care act and recent reforms: policy implications for equitable mental health care delivery Health Care Anal 28 3 2020 Sep 1 228 248 32103383
- [12]Ali M.M. Teich J. Woodward A. Han B. The implications of the affordable care act for behavioral health services utilization Adm Policy Ment Health Ment Health Serv Res 43 1 2016 Jan 1 11 22 25408457
- [13]Montz E. Layton T. Busch A.B. Ellis R.P. Rose S. McGuire T.G. Risk-adjustment simulation: plans may have incentives to distort mental health and substance use coverage Health Aff (Millwood) 35 6 2016 Jun 1022 1028 27269018 PMC5027954
- [14]Han B. Lai J. Yu H. Impact of the ACA Medicaid expansion on utilization of mental health care Med Care 58 9 2020 Sep 757 762 32732786 PMC7483910
- [15]Edlund M.J. Booth B.M. Han X. Who seeks care where? Utilization of mental health and substance use disorder treatment in two national samples of individuals with alcohol use disorders J Stud Alcohol Drugs 73 4 2012 Jul 635 646 22630802 PMC3364329
- [17]Rosner B. Neicun J. Yang J.C. Roman-Urrestarazu A. Substance use among sexual minorities in the US – linked to inequalities and unmet need for mental health treatment? Results from the National Survey on drug use and health (NSDUH) J Psychiatr Res 135 2021 Mar 1 107 118 33472121
- [19]Wang P.S. Lane M. Olfson M. Pincus H.A. Wells K.B. Kessler R.C. Twelve-month use of mental health services in the United States: results from the national comorbidity survey replication Arch Gen Psychiatry 62 6 2005 Jun 1 629 640 15939840
- [20]Neicun J. Yang J.C. Shih H. Nadella P. van Kessel R. Negri A. Lifetime prevalence of novel psychoactive substances use among adults in the USA: sociodemographic, mental health and illicit drug use correlates. Evidence from a population-based survey 2007–2014. Angkurawaranon C, editor PloS One 15 10 2020 Oct e0241056 PMC7598490 33125395
- [21]Yang J.C. Roman-Urrestarazu A. Brayne C. Binge alcohol and substance use across birth cohorts and the global financial crisis in the United States PloS One 13 6 2018 Jun 25 e0199741 PMC6016915 29940033
- [23]Roll J.M. Kennedy J. Tran M. Howell D. Disparities in unmet need for mental health Services in the United States, 1997–2010 Psychiatr Serv 64 1 2013 Jan 80 82 23280460
- [24]Walker E.R. Cummings J.R. Hockenberry J.M. Druss B.G. Insurance status, use of mental health services, and unmet need for mental health care in the United States Psychiatr Serv 66 6 2015 Jun 578 584 25726980 PMC4461054
- [25]Kessler R.C. Berglund P.A. Bruce M.L. Koch J.R. Laska E.M. Leaf P.J. The prevalence and correlates of untreated serious mental illness Health Serv Res 36 6 Pt 1 2001 Dec 987 1007 11775672 PMC1089274
- [26]Sareen J. Afifi TO McMillan K.A. Asmundson G.J.G. Relationship between household income and mental disorders: findings from a population-based longitudinal study Arch Gen Psychiatry 68 4 2011 Apr 4 419 427 21464366
- [30]Galea S. Ahern J. Tracy M. Vlahov D. Neighborhood income and income distribution and the use of cigarettes, alcohol, and marijuana Am J Prev Med 32 6, Supplement 2007 Jun 1 S195–202 PMC1974881 17543711
- [31]Patrick M.E. Wightman P. Schoeni R.F. Schulenberg J.E. Socioeconomic status and substance use among young adults: a comparison across constructs and drugs J Stud Alcohol Drugs 73 5 2012 Sep 772 782 22846241 PMC3410945
- [32]Jeffers A.M. Glantz S. Byers A. Keyhani S. Sociodemographic characteristics associated with and prevalence and frequency of cannabis use among adults in the US JAMA Netw Open 4 11 2021 Nov 30 e2136571 PMC8634054 34846523
- [34]Kerridge B.T. Chou S.P. Pickering R.P. Ruan W.J. Huang B. Jung J. Changes in the prevalence and correlates of cocaine use and cocaine use disorder in the United States, 2001–2002 and 2012–2013 Addict Behav 90 2019 Mar 1 250 257 30471553
- [36]Vitzthum L.K. Nalawade V. Riviere P. Sumner W. Nelson T. Mell L.K. Racial, ethnic, and socioeconomic discrepancies in opioid prescriptions among older patients with cancer JCO Oncol Pract 17 6 2021 Jun e703 e713 33534647 PMC8258011
- [37]Wells K. Klap R. Koike A. Sherbourne C. Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care Am J Psychiatry 158 12 2001 Dec 2027 2032 11729020
- [38]Mulvaney-Day N. DeAngelo D. Chen C. nan Cook B.L. Alegría M. Unmet need for treatment for substance use disorders across race and ethnicity Drug Alcohol Depend 125 2012 Sep 1 S44 S50 22658581 PMC3435455
- [39]Kuerbis A. Substance use among older adults: an update on prevalence, etiology, assessment, and intervention Gerontology. 66 3 2020 249 258 31812954
- [41]Baptiste-Roberts K. Hossain M. Socioeconomic disparities and self-reported substance abuse-related problems Addict Health 10 2 2018 Apr 112 122 31069035 PMC6494986
- [43]Rigg K.K. Monnat S.M. Comparing characteristics of prescription painkiller misusers and heroin users in the United States Addict Behav 51 2015 Dec 1 106 112 26253938 PMC4558364
- [44]Jones C.M. Logan J. Gladden R.M. Bohm M.K. Vital signs: demographic and substance use trends among heroin users — United States, 2002–2013 Morb Mortal Wkly Rep 64 26 2015 Jul 10 719 725 PMC4584844 26158353
- [47]Reuter P. Caulkins J.P. Midgette G. Heroin use cannot be measured adequately with a general population survey Addiction. 116 10 2021 2600 2609 33651441
- [48]Howard V. Holmshaw J. Inpatient staff perceptions in providing care to individuals with co-occurring mental health problems and illicit substance use J Psychiatr Ment Health Nurs 17 10 2010 862 872 21078001
- [49]Harwood H.J. Kowalski J. Ameen A. The need for substance abuse training among mental health professionals Adm Policy Ment Health Ment Health Serv Res 32 2 2004 Nov 1 189 205 15586850
Cited by
Sorted by citations
Cannabis use disorder and substance use treatment among U.S. adults
Choi, N. G., Moore, J., & Choi, B. Y. (2024) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2024.209486 · Cited by 22 · see citing works
Choi, N. G., & Marti, C. N. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22040640 · Cited by 8 · see citing works
“The finding that those with some college education and college graduates had lower odds of treatment receipt, compared to those with ≥ high school degrees, is consistent with the findings of previous studies [13,27] and suggests lower rates of perceived need for treatment among them [47].”
- Authors
- Dhinsa, J., Roman-Urrestarazu, A., van Kessel, R., & Humphreys, K.
- Affiliations
- University of Cambridge (GB)
- VA Palo Alto Health Care System (US)
- ORCID
- Humphreys, Keith
- Venue
- Global Epidemiology
- Publisher
- Elsevier BV
- Published
- 2023-12
- Volume
- 5
- Pages
- 100109
- ISSN
- 2590-1133 (ISSN-L)
- PMC
- PMC10445987
- OpenAlex
- W4366748342
- Cited by
- 13
- References
- 4
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 2 · 2023: 2
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Global Epidemiology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by-nc-nd)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- mental health treatment utilization, addiction treatment, access to mental health care, health care disparities, racial minorities, uninsured population, sexual minorities, gender differences, insurance status, Medicaid, opioid use disorder, cannabis use, cocaine use, social determinants of health, National Survey on Drug Use and Health
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