Access to conventional mental health and medical care among users of complementary and alternative medicine with bipolar disorder.

This research examined the role of perceived barriers to treatment as a potential contributor to the increasing use of complementary and alternative medicine (CAM) among mentally ill populations. The study examined a sample of 435 patients receiving care through the Veterans Administration Health System and having a current diagnosis of bipolar disorder (I, II, NOS), cyclothymia, or schizoaffective disorder-bipolar subtype. Access to care and use of any of 14 CAM therapies within the past year were studied. Physical CAM users reported slightly better mental health service access related to getting to mental health services and obtaining emergency mental health services when needed. Effect sizes for these differences were small (r(pb) = 0.09 and 0.13, respectively). Similarly, oral and cognitive CAM users indicated that they were slightly more likely to go without medical services when needed because they were too expensive. These effect sizes were also very small (r(pb) = 0.12 and 0.10, respectively), suggesting no clinical significance. Patients who reported use of oral and/or cognitive CAM therapies were slightly more likely than nonusers to go without medical care because of excessive costs. Patients having non-Veterans Affairs insurance reported no differences in rates of CAM use. Overall, no discernable trends were observed to suggest that CAM use among this sample was associated with service access.