Mental Health Treatment Access: Experience, Hypotheticals, and Public Opinion.

Policy Points Policymakers should consider both material (e.g., cost) and attitudinal (e.g., skepticism) barriers to mental health treatment access. Public support for government action on mental health is high but varies based on experience-based and hypothetical beliefs about barriers to treatment. Appeals to personal experience and perspective-taking may be successful in building support for government action on mental health.

Context: Mental health problems represent a major public health issue for the United States, and access to mental health treatment is both inadequate and unevenly distributed. There is a strong justification for government action on mental health treatment, but it is unclear whether there is a political constituency for such action. Existing work suggests that stigma and othering of people with mental illnesses contributes to reduced support for intervention. I expand on the existing literature by focusing on mental health as an issue that may apply to Americans' own lives rather than only to a stigmatized outgroup.

Methods: Using original questions on a nationally representative 2023 survey of 1,000 American adults, I measured agreement with statements about barriers to mental health treatment access that respondents have experienced or, if they have not sought treatment, their hypothetical assessment of these barriers. I also measured their support for statements in favor of change to address mental health. I analyzed the demographic and political correlates of agreement with the barrier statements and used regressions to examine their possible causal effect on support for change.

Findings: Agreement with statements about access barriers follows expected patterns in some cases (e.g., socioeconomic status) but not in others (e.g., race/ethnicity). I also documented a notable partisan and ideological divide in these experiences and beliefs. I found that Americans who agreed that material factors are a barrier to access were more supportive of action on mental health, whereas those who agreed with statements suggesting discomfort or skepticism were less supportive.

Conclusions: These findings suggest that personal experience and perspective-taking should be integrated into the study of public opinion on mental health, complementing existing work on stigma and othering. Appeals to experience and perspective-taking may be a successful strategy for building public support for action on mental health.