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social services, criminal justice,behavioral therapy, K-12 education, and others, and <br /> analyzed UNC Chapel Hill Emergency Department records. <br /> BARRIERS TO ACCESSING TREATMENT <br /> The primary findings of the assessment showed that existing levels of service do not <br /> adequately address the needs of this population although there are many examples of <br /> successful collaborations taking place across the county in an attempt to address the gaps. <br /> Responses from key opinion leaders around the barriers to accessing treatment for mental <br /> health and substance abuse helped to inform the findings included in the below table. <br /> These common themes were also incorporated into the survey questionnaire as a method <br /> for confirming their validity with a larger group. <br /> BARRIERS TO MENTAL HEALTH (MH)AND SUBSTANCE ABUSE (SA) <br /> TREATMENT AND RESOURCES <br /> Theme D$scription <br /> Affordability- #1 Gap The#1 gap in the OC mental health system is <br /> affordability. Many low-income residents <br /> either do not have insurance or find their <br /> coverage inadequately covers treatment <br /> services for MH and SA(e.g.must meet a high <br /> deductible before any coverage is provided, <br /> lack of reimbursement options,restricted to a <br /> low maximum number of appointments, etc.). <br /> This issue is exacerbated when adolescents age <br /> out of the Medicaid system at 18.There are <br /> very few sliding scale or pro bono options to fill <br /> this gap. Children and adolescents have <br /> difficulty with recovery if parents with mental <br /> health issues aren't treated as well,but parents <br /> run into these same issues with affordability. <br /> Transportation was ranked as the 2nd largest <br /> Location/Transportation - #2 Gap barrier to MH/SA services in Orange County. <br /> Services are especially scarce in the northern <br /> part of the county(i.e. Hillsborough and <br /> unincorporated areas). Public transportation <br /> helps somewhat with the older patients in the <br /> southern sector,but the younger ones still have <br /> unmet needs.This dilemma emphasizes the <br /> need for more accessible treatment centers and <br /> in/near-school care,especially when parents <br /> are unable to take their children to necessary <br /> appointments due to busy work schedules or <br /> other conflicts. <br /> Language/Cultural-#3 Gap For the most part, services for non-English <br /> speaking patients are either difficult to obtain <br /> or virtually inaccessible. 60%of respondents <br /> said it was difficult for non-English speaking <br />