Barriers to seeking and obtaining mental health services among atopic dermatitis patients

Summary: Abstract Body: Despite an established mental health (MH) burden among atopic dermatitis (AD) patients, there is a gap in diagnosis and treatment, and limited research on the barriers to accessing MH care in the context of AD. Logistic regressions were employed using data from an online survey of adult AD patients and caregivers of children aged 8-17 with AD (October to November 2023) to understand barriers to seeking and obtaining MH services. Among 986 participants, mostly female (68.6%) and White (66.4%), the largest barrier to seeking MH services was discomfort discussing MH (23.9%, 109/456). Structural barriers included uncertainty with how to find a MH provider (18.9%) and assuming/knowing that insurance would not cover MH services (14.5%). Some did not seek care because they thought it would not help (18.9%) or lacked confidence in the MH system (12.1%). Predictors of seeking MH services included race (Black: OR=1.38, p=0.189; Asian: OR=1.18, p=0.494; Other=1.85, p=0.003), sex (Female: OR=1.31, p=0.084), educational attainment (Four-year college, technical, or higher degree: OR=2.29, p=0.029), and the belief that eczema severity affects MH (OR=6.35, p<0.001). Predictors for those who successfully obtained MH services included ethnicity (Hispanic: OR=0.67, p=0.088), sex (Female: OR=1.95, p=0.007), insurance type (Medicaid: OR=0.49, p=0.042; Medicare/Tricare/VA: OR=0.46, p=0.01; Purchased: OR=0.36, p=0.001), and educational attainment (Four-year college, technical, or higher degree: OR=5.55, p=0.017). Participant-reported barriers highlight the role of social determinants of health, structural inaccessibility, and MH stigma in influencing access to MH care. AD providers can normalize MH challenges by educating patients on the AD-MH connection and the utility of MH services, encourage patients to seek MH care, and address structural barriers, which may be especially important for those who are less likely to seek or obtain services. Courtney Chau¹, Allison Loiselle², Jessica Johnson², Jennifer LeBovidge³, Lynda Schneider³, Wendy Smith Begolka² 1. Icahn School of Medicine at Mount Sinai, New York, NY, United States. 2. National Eczema Association, Novato, CA, United States. 3. Boston Children's Hospital, Boston, MA, United States. Clinical Research: Epidemiology and Observational Research