Page 44 - GHES-2-1

Global Health Econ Sustain

REVIEW ARTICLE
Access to interventional psychiatric treatments

in the United States: Disparities and proposed
solutions

Deepinder S. Nagra , Louise A. Stolz , Cory R. Weissman , and
1
2
2
2
Lawrence G. Appelbaum *
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

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
Academic editor: for improvement in efficacy and greater adoption. Despite the immense value and
Mihajlo Jakovljevic M.D. Ph.D. MAE
potential of interventional therapies, there are disparities in access to these treatments
*Corresponding author: owing to economic, cultural, and geographical factors. When compounded with
Lawrence G. Appelbaum
(lappelbaum@health.ucsd.edu) existing disparities in mental health care for racial and ethnic minorities, this
interaction worsens inequities in access and may exacerbate the severity of disease
Citation: Nagra, D.S., Stolz, L.A., in underserved groups. This review describes the factors contributing to these
Weissman, C.R. & Appelbaum, L.G.
(2024). Access to interventional disparities, suggests strategies to ameliorate inequities, and broadens the impact of
psychiatric treatments in the United interventional therapies.
States: Disparities and proposed
solutions. Global Health Econ
Sustain, 2(1): 2456. Keywords: Interventional psychiatry; Health-care disparities; Transcranial magnetic
https://doi.org/10.36922/ghes.2456
stimulation; Electroconvulsive therapy; Major depressive disorder
Received: December 16, 2023
Accepted: January 23, 2024
Published Online: March 5, 2024 1. Introduction
Copyright: © 2024 Author(s).
This is an Open-Access article Major depressive disorder (MDD) is a mood disorder characterized by persistent feelings
distributed under the terms of the of sadness, hopelessness, and a lack of interest or pleasure in daily activities, affecting
Creative Commons Attribution millions of individuals worldwide. MDD is one of the most prevalent and burdensome
License, permitting distribution,
and reproduction in any medium, illnesses globally, with approximately 19% of individuals experiencing it at least once in
provided the original work is their lifetime (Shorey et al., 2022). From an economic perspective, depression significantly
properly cited. impacts the economy due to its substantial costs and broader societal burdens. In 2018,
Publisher’s Note: AccScience the economic burden of MDD among adults in the United States was USD $326.2 billion
Publishing remains neutral with (Proudman et al., 2021), in comparison to cardiovascular diseases at USD $363 billion
regard to jurisdictional claims in
published maps and institutional (Benjamin et al., 2018), and cancer at USD $210 billion (Institute, 2023), underscoring
affiliations. the significant impact of MDD on individuals and society. While the prevalence of

Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/ghes.2456