Concurrent use of substance-use disorder treatment and mental healthcare in rural as compared to urban communities

Purpose This study aims to compare receipt of mental health (MH) treatment, substance-use disorder (SUD) treatment or the receipt of both types of treatment in adults in the USA according to rural−urban classification. Design/methodology/approach The authors analyzed the 2021–2022 National Survey on Drug Use and Health, a national convenience sample of the US noninstitutionalized population. The authors included adults between 18 and 64 years with predicted mental illness and SUD according to the Diagnostic and Statistical Manual for Mental Disorders, fifth edition criteria. The main outcome was the receipt of both MH and SUD treatment, only MH treatment, only SUD treatment or neither treatment. Findings Based on the analytic sample of 8,952 respondents, 2% received both MH and SUD treatment, 1% received only SUD treatment, 23% only MH treatment and 74% received neither type of treatment. The multivariable analysis found no association in the type of treatment received between rural−urban classification. The study analysis highlights persistent disparities based on patient demographics and economic status in the receipt of treatment addressing both MH and SUD but does not support the hypothesis of differential use of these treatments between rural and urban areas. Originality/value This study provides unique insight on the dynamics that influence the receipt of concurrent MH and SUD treatment in the USA. Concurrent treatment is effective in addressing the needs of MH and SUD in adults with both conditions; however, there is a substantial treatment gap in the USA, with little emphasis in research on the disparities in the receipt of concurrent treatment.