Non-English Communication Access in Mental Health and Substance Use Treatment Facilities in the U.S., 2024

Abstract Section 1557 of the Patient Protection and Affordable Care Act requires language access services in healthcare organizations receiving federal monies. In 2024, 32.0 percent of publicly funded mental health facilities and 39.9 percent of publicly funded substance use treatment facilities were in non-compliance with Section 1557. We present findings from across the United States using GIS mapping. We also present information on disparities in access to direct counseling in a non-English language. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study did not receive any funding. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes msully94{at}ufl.edu. jamesty{at}med.umich.edu. Data Availability Data are publicly available from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).