Measures of the Availability and Accessibility of Behavioral Health Services: A Scoping Review

Service availability and accessibility are necessary precursors to scaling up behavioral health services. This review aimed to examine the literature in order to identify and summarize quantitative measurement approaches to assessing the availability and accessibility of behavioral health services. The search used in this scoping review included terms for psychiatric diagnoses, behavioral health services, measurement, and availability and accessibility. Databases queried were CINAHL, MEDLINE, PsycInfo, Embase, and Web of Science. Two coders first screened the titles and abstracts and then the full texts of retrieved articles. Articles were included if they discussed a behavioral health service outcome and provided sufficient description of their quantitative measures or measurement approach. Two researchers extracted data from each article that met the inclusion criteria and deductively coded measures by using availability and accessibility domains derived from existing frameworks. The search yielded 266 articles containing 250 unique measurement approaches. Articles most frequently used secondary (vs. nonsecondary) data sources. Measures were often developed for a single study; 93% of the unique measures were used only once. Only 12% of the measures had psychometric properties reported. The availability and accessibility domains had uneven coverage across secondary sources and unique measures. One brief, public-facing, psychometrically tested measure was found, but it lacked one of the availability domains. Availability and accessibility should be treated as constructs distinct from utilization. National surveys provide indispensable information about the availability and accessibility of behavioral health services. The field would benefit from having a brief, client- and public-facing, psychometrically tested measure covering core availability and accessibility domains.