Research shows that gaps exist in mental health care for people with chronic pain

A new study from the University of Arizona Health Sciences found that adults with chronic pain are more likely to experience symptoms of anxiety and depression than people without chronic pain, yet they still access mental health care at lower rates and are less likely to their mental health needs are met during treatment.

The article “The Unmet Mental Health Needs of American Adults Living with Chronic Pain” was published in the news Pain.

According to the Centers for Disease Control and Prevention, approximately 51.6 million American adults experienced chronic pain in 2021. The study found that while people with chronic pain represent 20.4% of the U.S. adult population, they make up an estimated 55.5% of U.S. adults with clinically significant anxiety and depression symptoms.

“The mental health movement in the United States has been extremely successful, and many people are living better lives as a result,” said lead author Jennifer S. De La Rosa, Ph.D., director of strategy for the U of A Health Sciences. Comprehensive center for pain and addiction.

“But among those whose mental health needs have not yet been effectively addressed, the experience of chronic pain is not the exception, but the rule. The needs of people with chronic pain are too often left out of our national mental health conversation.

“Our findings suggest that meaningful engagement with the lived experiences of people with chronic pain should be a focus of our national mental health agenda going forward.”

This study builds on previous research from the Comprehensive Center for Pain & Addiction that found that one in 20 American adults has a combination of chronic pain and symptoms of anxiety or depression, and that adults with chronic pain are approximately five times more likely to untreated symptoms of anxiety or depression. anxiety or depression compared to people who do not live with chronic pain.

The new study examined the extent to which people with chronic pain and mental health symptoms accessed and benefited from mental health care.

The research team analyzed data from 31,997 people who participated in the National Health Interview Survey, which has been identified as the best source for chronic pain surveillance. Researchers identified disparities associated with chronic pain in three areas: the need for mental health treatment; the use of mental health services; and the success of treating anxiety and depression symptoms when mental health treatment was used.

They found that 43.2% of American adults with chronic pain – about 21.5 million people – had a need for mental health care. By comparison, mental health needs were identified in only 17.4% of US adults who do not have chronic pain.

Among all US adults with a mental health treatment need, chronic pain was associated with a 40.3% reduction in the odds of using mental health treatment.

“For people with chronic pain, the story of what needs to be done to address mental health is qualitatively different than for those who do not have chronic pain,” said De La Rosa, assistant research professor at the College of Medicine. – Tucson’s Department of Family and Community Medicine.

“Improving health care for people with chronic pain involves not only connecting people to care, but also addressing a disproportionate inability to achieve relief, even in the context of care delivery.”

Researchers found that when using mental health treatment, American adults with chronic pain are more than twice as likely as others to experience persistent anxiety or depression symptoms.

The research team found that only 44.4% of people with chronic pain, an estimated 9.5 million people, used mental health care and had their anxiety and depression symptoms adequately treated, compared to 71.5% of those without chronic pain. pain. When mental health treatment was used, American adults with chronic pain were more than twice as likely as others to experience persistent anxiety or depression symptoms.

“There are many possible reasons why a person with chronic pain may receive suboptimal outcomes from mental health care, including accessibility of care and feasibility of attending appointments,” De La Rosa said.

“Additionally, few mental health providers are trained in chronic pain, so only a small percentage of people with chronic pain are likely to receive mental health treatment designed to meet their needs.

“By further examining the role that chronic pain plays in our national mental health crisis, we have a potentially transformative scientific and policy opportunity to build the capacity of the U.S. health care system to address co-occurring chronic pain and mental health challenges.”

“This study has identified a significant gap in meeting the mental health needs of people living with chronic pain,” said senior author Todd Vanderah, Ph.D., director of the Comprehensive Center for Pain & Addiction, Regents Professor and head of the Department of Pharmacology at the College of Medicine-Tucson and a member of the BIO5 Institute.

“Our goal at the Comprehensive Center for Pain & Addiction is to use this information to reimagine and transform healthcare for chronic pain. By recognizing and treating the co-occurrence of anxiety and depression symptoms and chronic pain, we can empowering millions of people, people affected by pain can thrive.”