Access to Behavioral Health Appointments and Care

Access to Behavioral Health Appointments and Care

Access to mental health services is uneven

Missed mental health appointments are a risk factor for all-cause mortality, according to a 2019 BMC Medicine study, with mental health patients experiencing an eightfold increase in risk. The poor access to mental health treatment is exacerbated in rural areas by 1) the shortage of mental health professionals in rural America, 2) the subsequently longer distances individuals have to travel to access such services, and 3) the low frequency of rural public transportation services to transport individuals to services. 

Simplifying Transportation Access for Behavioral Health Patients
This NCMM Video shows lessons learned from one of our Design Challenge teams in El Paso County, Colorado in making it easier for behavioral health patents to routinely access care. 

The Importance of Consistency and Predictability in Transportation Services for Behavioral Health Patients
This NCMM Video shows lessons learned from one of our Design Challenge grantees in Flint, Michigan on how to ensure community members are not missing behavioral health appointments. 

Transportation and substance use disorder treatment

Treatment for substance use disorders (SUDs) has different phases and activities, each of which informs the associated transportation need.

The acute phase is where an individual chooses to enter intensive treatment to address their addiction to a substance.  A person’s first point of contact with substance abuse treatment may be a medical doctor or mental health professional who then refers the person to an addiction treatment program. While treatment at this initial stage may be provided in outpatient settings, people with more severe or long-term instances of addiction might need inpatient or residential care. It is important for an individual, once referred to a treatment center, to enroll in treatment immediately while they are still open to treatment.

Transportation to SUD treatment can be an issue, even with outpatient treatment centers, as they may not be on a public transit route, and even if they are, a public bus may not be the most appropriate choice for the individual at that point in time as they may encounter other individuals with whom they used or from whom they bough substances in the past. 

Transportation to residential treatment centers may be even more difficult; because there is such a demand for their services, there is often a waitlist for these services, and case managers may only be able to locate a center far from the individual’s home. The individual may not have friends, family, or other contacts to help the individual get to that center.

In the recovery phase, the individual’s need for transportation may be significant. Recovery may include several different types of activities, listed below with their associated transportation need:

  • Group and individual therapy — usually occurs on a regular schedule, or at least scheduled in advance, apart from crisis situations
  • Random urinalysis — intentionally not on a regular schedule, needs access to on-demand transportation
  • Medically assisted treatment (“MAT,” such as methadone) — may be a daily occurrence for dosing, which implies the need for intensive level transportation
  • Physical health appointments — usually scheduled in advance, apart from crisis situations


Embracing a Community Network to Support Recovery from Addiction
This NCMM Video shows lessons learned from one of our Design Challenge grantees in Shiawassee, Michigan on creating a system to help community members recover from addiction. 

For further investigation . . .

Barriers to Mental Health Treatment in Rural Areas

This tool provides data on a set of transportation and public health indicators for each U.S. state and metropolitan area that describe how the transportation environment affects safety, active transportation, air quality, and connectivity to destinations.

Additional resources

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