Mental Health Care Access Using Geographic Information Systems: An Integrative Review.

A decade after the Mental Health Parity and Addiction Equity Act was implemented to ensure access to mental health and substance abuse services for U.S. citizens, accessing mental health care still is problematic for many needing services. More than 123 million Americans reside in federally-designated Mental Health Professional Shortage Areas (MHPSA) compared to 84 million living in similarly-designated primary care shortage areas and 62 million in dental health shortage areas. Health professional shortage areas are geographic areas that have a shortage of primary medical, dental, or mental health providers. Geographic Information Systems (GIS) with spatial analysis approaches provide tools to understand the ever-changing distribution of health care, outcomes, and delivery to improve care. The aim of this integrative review is to describe and synthesize the literature on GIS approaches to improve access to mental health care services. GIS Bibliography, PubMed, CINAHL, PsycINFO, Academic Search Premier, Social Sciences Citation Index, and Oalster were searched for articles between January 1, 1998 and January 1, 2018 that met established inclusion/exclusion criteria. Among the 138 articles reviewed, 18 met criteria and were included in the review. GIS approaches to improve access to mental health care can be categorized as (1) type of care (integrated, community), (2) contributions to access (distance, time, cost, perception of traveling, inequalities), and (3) the utilization of services. Results from the literature suggest closer examination of measures used to assess geographic variations in accessibility is needed for ultimately improving quality of care for people in MHPSA.