Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review

• Co-occurring disorders are associated with low service use and negative outcomes.
• We examine treatment access barriers for persons with co-occurring disorders.
• Treatment access barriers include personal characteristics and structural barriers.
• Few studies examine access barriers for older, non-White, non-heterosexual persons.
• Studies on treatment access barriers for underrepresented groups are needed.

The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-White, non-heterosexual populations.