Two studies conclude more people than in the past have multiple mental disorders, and there aren’t enough services to help those with mental health problems.

When it comes to mental illness in the United States, the healthcare system may come up short for those who need it most.

A new study published today from the New York University School of Medicine concludes that many people with mental health issues encounter significant barriers to proper medical treatments.

That’s despite new legislation, in particular the Affordable Care Act (ACA), approved in 2010.

Researchers examined serious psychological distress (SPD) in adults between 2006 and 2014.

They wrote that they discovered that “compared with adults without SPD, adults with SPD had an increased risk of forgoing healthcare and prescription medications because of cost and were more likely to be uninsured.”

SPD is not a diagnosis for mental illness but rather a scale used to measure the mental health of a given community by gauging negative emotions such as sadness, hopelessness, and nervousness, Judith Weissman, PhD, JD, research manager at New York University, and lead author of the study, told Healthline.

“SPD strongly covaries with serious mental illness,” she said. “It is associated with reduced functioning, and an inability to work or attend school, and causes impairment with daily living based on the negative emotional states.”

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The researchers used data from the National Health Interview Survey, an assessment conducted by the U.S. Census Bureau.

Weissman and her team were able to compare healthcare utilization of those with SPD with those without it.

Healthcare utilization was measured through a series of metrics including inability to buy prescription drugs because of money issues, delay in healthcare because of a lack of money, or having to change where they sought treatment due to insurance issues.

In 2006, the first year of the survey, 9 percent of Americans with SPD didn’t have health insurance.

In 2014 that number was slightly higher at 9.5 percent.

Similarly, in 2006, 9 percent experienced delays getting treatment due to lack of mental health coverage. By 2014 that number increased to 10 percent.

“Based on our data, we estimate that millions of Americans have a level of emotional functioning that leads to lower quality of life and life expectancy,” Weissman said in a press release.

Furthermore, she told Healthline, adults with SPD “appear to have more chaotic and less effective use of healthcare compared to those without, hence they are in poorer health.”

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Compounding the problem of accessibility, a new study from Duke University also points out that those with mental illness may often suffer from more than just one disorder.

Researchers examined the prevalence and potential reasons for “comorbidity” a term used to describe when an individual has multiple mental disorders at once.

Approximately half of individuals who meet the criteria for a single mental disorder will also meet the criteria for a second disorder, researchers say. That makes treatment even more difficult.

“Clinically, comorbidity is associated with greater severity of impairment and complexity in treatment planning, compliance, and coordination of services,” the study authors wrote.

Researchers examined the “p-factor,” a statistical way to measure the overlap of different kinds of mental illness, such as depression, anxiety, and substance abuse.

A person with many of these issues would have a higher p-factor score than someone with one mental health condition.

Practically, “the p-factor suggests that there may be a general factor of psychopathology” that can be accounted for. The study authors say that this could provide a new way to approach treatment of mental illness.

“If we continue to find support for the link between the ‘p-factor’ and the cerebellum, our research raises interesting questions about when and how this link emerges and how we might use that information to intervene more effectively,” study authors Ahmad Hariri, PhD, and Adrienne Romer, told Healthline.

“There may be more efficient ways of treating mental illnesses by targeting their shared characteristics,” they said.

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