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