Mental Health Services at a Free Clinic: Pilot Responses to a Patient Survey
Abstract
Introduction and Objective. Mental health concerns are prevalent in free clinics. The life stressors and resulting social determinants of health that affect this patient population are vast, and often propose additional challenges to a clinic already resource poor. Few published studies exist that focus on patient-perceived limitations to satisfactory mental health care and realistic suggestions for improvement in this setting. The objective of this study was to understand patient-reported barriers to mental health services at a South Florida free clinic. Methods. An electronic, iPad-based survey consisting of demographic and Likert-type questions was distributed to a convenience sample of adult patients at our free clinic from June 2023 to August 2023. The survey was available in English, Spanish, and Creole. Patients were asked about their prior experiences with mental health services and challenges they face in accessing treatment. Descriptive statistics consisting of basic demographic data and Likert averages were tabulated (1-Strongly Disagree to 5-Strongly Agree). Results. Seventy-three patients consented to the survey. Seven (9.6%) of the patients reported use of mental health services within the previous 12 months by either a provider appointment or emergency room visit. As the remainder of the survey asked questions specifically regarding opinions of mental health services and factors that would allow patients to increase use of such services, only the seven patients that reported previous utilization of mental health resources were included in the analysis. The majority of the included respondents identified as male, between the ages of 18-40, and of Hispanic/Latino ethnicity. Patients reported lack of health insurance as the largest barrier to accessing mental health services. Inability to afford visits and/or medications, lack of perceived usefulness of previous services, time constraints due to other responsibilities, and immigration status were also challenges identified by patients. Support from family and friends was rated as the most significant factor that would aid access to mental health services. Ensuring basic needs were met and increased flexibility of provider scheduling were also of high importance. Patients expressed greater interest in telehealth than in-person mental health services. Conclusions-Implications. Recognizing the specific challenges faced by patients is important in determining solutions to enhance utilization of mental health services in the free clinic setting. Lack of health insurance and financial burden of visits and/or medications may limit referral and treatment options. Patients felt that flexibility of scheduling and telehealth availability would help increase utilization of services. Although limited by a small sample, these responses support the hiring of an in-house social worker or licensed therapist to facilitate access to mental health services.
Keywords
depression, mental health, free clinic, medically underserved, social determinants
Presentation Type
Poster Presentation
Mental Health Services at a Free Clinic: Pilot Responses to a Patient Survey
Introduction and Objective. Mental health concerns are prevalent in free clinics. The life stressors and resulting social determinants of health that affect this patient population are vast, and often propose additional challenges to a clinic already resource poor. Few published studies exist that focus on patient-perceived limitations to satisfactory mental health care and realistic suggestions for improvement in this setting. The objective of this study was to understand patient-reported barriers to mental health services at a South Florida free clinic. Methods. An electronic, iPad-based survey consisting of demographic and Likert-type questions was distributed to a convenience sample of adult patients at our free clinic from June 2023 to August 2023. The survey was available in English, Spanish, and Creole. Patients were asked about their prior experiences with mental health services and challenges they face in accessing treatment. Descriptive statistics consisting of basic demographic data and Likert averages were tabulated (1-Strongly Disagree to 5-Strongly Agree). Results. Seventy-three patients consented to the survey. Seven (9.6%) of the patients reported use of mental health services within the previous 12 months by either a provider appointment or emergency room visit. As the remainder of the survey asked questions specifically regarding opinions of mental health services and factors that would allow patients to increase use of such services, only the seven patients that reported previous utilization of mental health resources were included in the analysis. The majority of the included respondents identified as male, between the ages of 18-40, and of Hispanic/Latino ethnicity. Patients reported lack of health insurance as the largest barrier to accessing mental health services. Inability to afford visits and/or medications, lack of perceived usefulness of previous services, time constraints due to other responsibilities, and immigration status were also challenges identified by patients. Support from family and friends was rated as the most significant factor that would aid access to mental health services. Ensuring basic needs were met and increased flexibility of provider scheduling were also of high importance. Patients expressed greater interest in telehealth than in-person mental health services. Conclusions-Implications. Recognizing the specific challenges faced by patients is important in determining solutions to enhance utilization of mental health services in the free clinic setting. Lack of health insurance and financial burden of visits and/or medications may limit referral and treatment options. Patients felt that flexibility of scheduling and telehealth availability would help increase utilization of services. Although limited by a small sample, these responses support the hiring of an in-house social worker or licensed therapist to facilitate access to mental health services.