Access to outpatient mental health care in Walla Walla County

Access to mental health care has repeatedly been identified as an area of concern in Walla Walla County. However, few details are known about barriers that limit local access to care and whether these barriers differ across sociodemographic groups. This exploratory study set out to determine specific barriers to care by comparing county residents’ experiences of accessing outpatient mental health services. Additionally, this research examined potential disparities in access to care by comparing experiences of county residents with private and public health insurance. Twenty county residents, 9 with private insurance and 11 with public insurance, participated in semi-structured interviews to discuss their access to mental health services within the county. Framework analysis was used to identify several themes and sub-themes to describe barriers faced by individuals in need of local mental health services. Analysis relied on a general framework of barriers to care proposed by the nonprofit Health Care for All. This framework was used to categorize participants’ experiences into four themes: knowledge, attitude, price & insurance, and delivery-related barriers to care. Results yielded nine specific sub-themes that capture precise barriers to care across all participants, ranging from ‘problems with prescribers’ to ‘stigma in a small community.’ Few substantial differences in barriers to care were found between insurance groups, although privately insured individuals tended to have higher out-of-pocket costs and broader access to private mental health practitioners. Recommendations for how mental health providers, doctors, and county leaders can mitigate barriers are discussed.