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16 <br /> Inpatient Care Usage/Access-barrier between 2009 and 2012,we have begun to see <br /> identified through stakeholder interviews a large increase in visits for patients 0-24 <br /> and survey responses (cont'd) (51/%).This increase supports reports of ED <br /> overcrowding we've received from UNC <br /> Hospitals. The percentage increase of youth <br /> mental health ED visits is also increasing at a <br /> faster rate than overall mental health ED visits <br /> (25%compared to 18%.) In the case of <br /> substance abuse, 29%of all mental health ED <br /> visits for 0-24 year olds are substance abuse <br /> related. <br /> Disorder/Diagnosis Type -barrier Survey data indicates that generalized anxiety <br /> identified through stakeholder interviews disorder and major depressive disorder are the <br /> and survey responses two mental illnesses that most frequently affect <br /> residents aged 0-25 in Orange County(93% <br /> and 89%respectively) and are also the easiest <br /> to refer for treatment. Drug and alcohol abuse <br /> were also frequent diagnoses (80%of <br /> respondents for both) however, only 39%of <br /> respondents found them easy to refer for <br /> treatment. Schizophrenia spectrum and other <br /> psychotic disorders were deemed the most <br /> difficult to refer for treatment(25%) and <br /> treatment for eating disorders was said to be <br /> the most inaccessible (11%). <br /> CONCLUSION <br /> The most common barriers for people in Orange County aged 0-25 who need mental health <br /> and/or substance abuse treatment services were affordability and accessibility. <br /> Affordability <br /> One of the biggest barriers to accessing services, even when they are available, is the lack of <br /> services that are provided based on a person's ability to pay.Any improvement to the <br /> mental health system in Orange County will need to address the affordability of these <br /> services. <br /> Accessibility <br /> We found that the ability to access services depends on a variety of factors (service type, <br /> location, eligibility and cultural/linguistic appropriateness) all of which have gaps. Certain <br /> types of services such as substance abuse treatment and psychiatric care are hard to find. <br /> The location of mental health services in the population centers makes them difficult for <br /> this age group to access. Restrictions on who can receive services (e.g., age, citizenship, <br /> diagnosis) results in decreased access. Finally,the inability to provide needed mental <br /> health services in a linguistically and culturally appropriate manner significantly limits <br /> access. <br />