Health Systems Issues and the Underserved

A number of factors endemic to the U.S. health system contribute to barriers to meeting the mental health needs of the underserved. Important variables include the economic barrier of continued gaps in affordable third-party coverage for care, perceived and actual costs of care, insufficient numbers of clinicians relative to the number of individuals in need of mental health services, and training and workforce gaps to meet specific needs (e.g., culture, disability, geographical) of the population. Approaches being developed to counter the limited-access problem include increasing economic support for coverage of services, expanding the workforce, incorporating ethics and cultural competence in clinical training, educating consumers about real costs of care, and developing volunteer and charitable models of service provision. Future developments to decrease health system barriers are likely to include technological advances.