Medical debt tied to higher likelihood of forgone mental health care

More than one in seven adults reported carrying medical debt in 2023, and of these, one in three forwent mental health care in the subsequent year, according to a research letter published online April 18 in JAMA Health Forum.

Kyle J. Moon, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues evaluated the association between medical debt and forgone mental health care due to cost in the subsequent year. The analysis included data from 1,821 adults surveyed in 2023 through 2024 as part of the COVID-19 Life Stressors Impact on Mental Health and Well-Being study.

The researchers found that forgone mental health care was significantly higher among adults with past-year medical debt (33.8% versus 6.3% weighted). There was an association between any medical debt and an increase of 17.3 percentage points in the probability of forgone mental health care due to cost. There was an increase in the probability of unmet mental health care needs with increasing medical debt.

“While there are a constellation of factors leading to unmet needs for mental health care, medical debt is an iatrogenic problem that leaves patients grappling with the decision to pay large out-of-pocket costs, accumulate medical debt, or forgo needed care,” the authors write.

“Several policy efforts to address medical debt are underway, and there remains an urgent need to understand how these interventions protect against medical debt and if such protections can aid in addressing unmet needs for mental health care.”

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