International comparisons of disparities in access to care for people with mental health conditions

Objective: Relatively little is known about experiences of barriers in access to overall care for people with mental health conditions (MHCs), or disparities between people with and without MHCs, or how patterns vary across countries. Data and method: The 2016 Commonwealth Fund International Health Policy Survey of adults was used to compare access barriers for people with MHCs across 11 countries, and disparities within countries between people with and without an MHC, using normalized scores. Disparities were also assessed by using multivariable models adjusting for age, sex, immigrant status, income, and self-rated health. Result: On average, people with MHCs had a higher prevalence of barriers, with a gap of 7 percentage points between people with and without MHCs. The gap ranged from 5 to 9% across countries. For people with an MHC, the most common access barriers were skipping care due to cost (26%) and receiving conflicting information from providers (26%). For all countries, having an MHC was associated with higher odds of experiencing barriers of access to care on several measures, with at least 1 case where the adjusted odds were greater than 2. Conclusion: There is an imperative to improve monitoring of access to overall health care for people with MHCs and an opportunity learn from countries with fewer barriers and disparities in access to care.