Access to interventional psychiatric treatments in the United States: Disparities and proposed solutions

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.