AccScience Publishing / GHES / Online First / DOI: 10.36922/ghes.2456
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Access to interventional psychiatric treatments in the United States: Disparities and proposed solutions

Deepinder S. Nagra1 Louise A. Stolz2 Cory R. Weissman2 Lawrence G. Appelbaum2*
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1 Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis Health Center, Sacramento, California, United States of America
2 Department of Psychiatry, Interventional Psychiatry Program, University of California San Diego, La Jolla, California, United States of America
Submitted: 16 December 2023 | Accepted: 23 January 2024 | Published: 5 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Interventional psychiatric treatments are a group of mental health procedures and monitored pharmacological interventions that are implemented when first-line therapies, such as psychotherapy and traditional pharmacotherapy, are ineffective or when there is a need for rapid symptom relief. Interventional treatments such as repetitive transcranial magnetic stimulation, esketamine, and electroconvulsive therapy are the United States Food and Drug Administration -approved treatments for major depressive disorder that has gained increased use and shows promise for improvement in efficacy and greater adoption. Despite the immense value and potential of interventional therapies, there are disparities in access to these treatments owing to economic, cultural, and geographical factors. When compounded with existing disparities in mental health care for racial and ethnic minorities, this interaction worsens inequities in access and may exacerbate the severity of disease in underserved groups. This review describes the factors contributing to these disparities, suggests strategies to ameliorate inequities, and broadens the impact of interventional therapies.

Keywords
Interventional psychiatry
Health-care disparities
Transcranial magnetic stimulation
Electroconvulsive therapy
Major depressive disorder
Funding
Kreutzkamp Family Foundation
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Conflict of interest
The authors declare that they have no competing interests.
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