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Kuper H, Azizatunnisa' L, Gatta DR, Rotenberg S, Banks LM, Smythe T, Heydt P. Building disability-inclusive health systems. Lancet Public Health 2024; 9:e316-e325. [PMID: 38702096 DOI: 10.1016/s2468-2667(24)00042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/20/2023] [Accepted: 02/21/2024] [Indexed: 05/06/2024]
Abstract
Health systems often fail people with disabilities, which might contribute to their shorter life expectancy and poorer health outcomes than people without disabilities. This Review provides an overview of the existing evidence on health inequities faced by people with disabilities and describes existing approaches to making health systems disability inclusive. Our Review documents a broad range of health-care inequities for people with disabilities (eg, lower levels of cancer screening), which probably contribute towards health differentials. We identified 90 good practice examples that illustrate current strategies to reduce inequalities. Implementing such strategies could help to ensure that health systems can expect, accept, and connect people with disabilities worldwide, deliver on their right to health, and achieve health for all.
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Affiliation(s)
- Hannah Kuper
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Missing Billion Initiative, Seattle, WA, USA.
| | - Luthfi Azizatunnisa'
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Danae Rodríguez Gatta
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Missing Billion Initiative, Seattle, WA, USA
| | - Sara Rotenberg
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lena Morgon Banks
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Tracey Smythe
- Department of Population Health, International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK; Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
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Meiselbach MK, Ettman CK, Shen K, Castrucci BC, Galea S. Unmet need for mental health care is common across insurance market segments in the United States. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae032. [PMID: 38756925 PMCID: PMC10986235 DOI: 10.1093/haschl/qxae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 05/18/2024]
Abstract
A substantial proportion of individuals with depression in the United States do not receive treatment. While access challenges for mental health care have been documented, few recent estimates of unmet mental health needs across insurance market segments exist. Using nationally representative survey data with participant-reported depression symptom severity and mental health care use collected in Spring 2023, we assessed access to mental health care among individuals with similar levels of depression symptom severity with commercial, Medicare, Medicaid, and no insurance. Among individuals who reported symptoms consistent with moderately severe to severe depression, 37.8% did not have a diagnosis for depression (41.0%, 28.1%, 33.6%, and 56.3% with commercial, Medicare, Medicaid, and no insurance), 51.9% did not see a mental health specialist (49.7%, 51.7%, 44.9%, and 91.8%), and 32.4% avoided mental health care due to affordability in the past 12 months (30.2%, 34.0%, 21.1%, and 54.8%). There was substantial unmet need for mental health treatment in all insurance market segments, but especially among individuals without insurance.
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Affiliation(s)
- Mark K Meiselbach
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Catherine K Ettman
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Karen Shen
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | | | - Sandro Galea
- Boston University School of Public Health, Boston, MA 02118, United States
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Harris SJ, Golberstein E, Maclean JC, Stein BD, Ettner SL, Saloner B. How policymakers innovate around behavioral health: adoption of the New Mexico "No Behavioral Health Cost-Sharing" law. HEALTH AFFAIRS SCHOLAR 2024; 2:qxad081. [PMID: 38756394 PMCID: PMC10986291 DOI: 10.1093/haschl/qxad081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 05/18/2024]
Abstract
State policymakers have long sought to improve access to mental health and substance use disorder (MH/SUD) treatment through insurance market reforms. Examining decisions made by innovative policymakers ("policy entrepreneurs") can inform the potential scope and limits of legislative reform. Beginning in 2022, New Mexico became the first state to eliminate cost-sharing for MH/SUD treatment in private insurance plans subject to state regulation. Based on key informant interviews (n = 30), this study recounts the law's passage and intended impact. Key facilitators to the law's passage included receptive leadership, legislative champions with medical and insurance backgrounds, the use of local research evidence, advocate testimony, support from health industry figures, the severity of MH/SUD, and increased attention to MH/SUD during the COVID-19 pandemic. Findings have important implications for states considering similar laws to improve access to MH/SUD treatment.
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Affiliation(s)
- Samantha J Harris
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Ezra Golberstein
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, United States
| | | | | | - Susan L Ettner
- Department of Medicine, Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA 90095, United States
- Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Brendan Saloner
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, United States
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Hoffmann JA, Pulcini CD, Hall M, De Souza HG, Alpern ER, Chaudhary S, Ehrlich PF, Fein JA, Fleegler EW, Goyal MK, Hargarten S, Jeffries KN, Zima BT. Timing of Mental Health Service Use After a Pediatric Firearm Injury. Pediatrics 2023; 152:e2023061241. [PMID: 37271760 PMCID: PMC10694862 DOI: 10.1542/peds.2023-061241] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/10/2023] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVES To examine how timing of the first outpatient mental health (MH) visit after a pediatric firearm injury varies by sociodemographic and clinical characteristics. METHODS We retrospectively studied children aged 5 to 17 years with a nonfatal firearm injury from 2010 to 2018 using the IBM Watson MarketScan Medicaid database. Logistic regression estimated the odds of MH service use in the 6 months after injury, adjusted for sociodemographic and clinical characteristics. Cox proportional hazard models, stratified by previous MH service use, evaluated variation in timing of the first outpatient MH visit by sociodemographic and clinical characteristics. RESULTS After a firearm injury, 958 of 2613 (36.7%) children used MH services within 6 months; of these, 378 of 958 (39.5%) had no previous MH service use. The adjusted odds of MH service use after injury were higher among children with previous MH service use (adjusted odds ratio, 10.41; 95% confidence interval [CI], 8.45-12.82) and among non-Hispanic white compared with non-Hispanic Black children (adjusted odds ratio, 1.29; 95% CI, 1.02-1.63). The first outpatient MH visit after injury occurred sooner among children with previous MH service use (adjusted hazard ratio, 6.32; 95% CI, 5.45-7.32). For children without previous MH service use, the first MH outpatient visit occurred sooner among children with an MH diagnosis made during the injury encounter (adjusted hazard ratio, 2.72; 95% CI, 2.04-3.65). CONCLUSIONS More than 3 in 5 children do not receive MH services after firearm injury. Previous engagement with MH services and new detection of MH diagnoses during firearm injury encounters may facilitate timelier connection to MH services after injury.
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Affiliation(s)
- Jennifer A. Hoffmann
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christian D. Pulcini
- Department of Emergency Medicine & Pediatrics, University of Vermont Medical Center and Children’s Hospital, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Matt Hall
- Children’s Hospital Association, Lenexa, KS, USA
| | | | - Elizabeth R. Alpern
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sofia Chaudhary
- Department of Pediatrics and Emergency Medicine, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter F. Ehrlich
- Section of Pediatric Surgery, CS Mott Children’s Hospital University of Michigan Ann Arbor, Michigan, USA
| | - Joel A. Fein
- Department of Pediatrics, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Eric W. Fleegler
- Departments of Pediatrics and Emergency Medicine, Harvard Medical School; Division of Emergency Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Monika K. Goyal
- Department of Pediatrics, Children’s National Hospital, George Washington University, Washington, DC, USA
| | - Stephen Hargarten
- Department of Emergency Medicine, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristyn N. Jeffries
- Department of Pediatrics, Section of Hospital Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Bonnie T. Zima
- UCLA-Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
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Presskreischer R, Barry CL, Lawrence AK, McCourt A, Mojtabai R, McGinty EE. Factors Affecting State-Level Enforcement of the Federal Mental Health Parity and Addiction Equity Act: A Cross-Case Analysis of Four States. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2023; 48:1-34. [PMID: 36112956 PMCID: PMC9938503 DOI: 10.1215/03616878-10171062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
CONTEXT The Mental Health Parity and Addiction Equity Act (MHPAEA) requires coverage for mental health and substance use disorder (MH/SUD) benefits to be no more restrictive than for medical/surgical benefits in commercial health plans. State insurance departments oversee enforcement for certain plans. Insufficient enforcement is one potential source of continued MH/SUD treatment gaps among commercial insurance enrollees. This study explored state-level factors that may drive enforcement variation. METHODS The authors conducted a four-state multiple-case study to explore factors influencing state insurance offices' enforcement of MHPAEA. They interviewed 21 individuals who represented state government offices, advocacy organizations, professional organizations, and a national insurer. Their analysis included a within-case content analysis and a cross-case framework analysis. FINDINGS Common themes included insurance office relationships with other stakeholders, policy complexity, and political priority. Relationships between insurance offices and other stakeholders varied between states. MHPAEA complexity posed challenges for interpretation and application. Policy champions influenced enforcement via priorities of insurance commissioners, governors, and legislatures. Where enforcement of MHPAEA was not prioritized by any actors, there was minimal state enforcement. CONCLUSIONS Within a state, enforcement of MHPAEA is influenced by insurance office relationships, legal interpretation, and political priorities. These unique state factors present significant challenges to uniform enforcement.
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Nelson KL, Powell BJ, Langellier B, Lê-Scherban F, Shattuck P, Hoagwood K, Purtle J. State Policies that Impact the Design of Children's Mental Health Services: A Modified Delphi Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:834-847. [PMID: 35737191 PMCID: PMC9219374 DOI: 10.1007/s10488-022-01201-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 12/22/2022]
Abstract
To identify the state-level policies and policy domains that state policymakers and advocates perceive as most important for positively impacting the use of children's mental health services (CMHS). We used a modified Delphi technique (i.e., two rounds of questionnaires and an interview) during Spring 2021 to elicit perceptions among state mental health agency officials and advocates (n = 28) from twelve states on state policies that impact the use of CMHS. Participants rated a list of pre-specified policies on a 7-point Likert scale (1 = not important, 7 = extremely important) in the following policy domains: insurance coverage and limits, mental health services, school and social. Participants added nine policies to the initial list of 24 policies. The "school" policy domain was perceived as the most important, while the "social" policy domain was perceived as the least important after the first questionnaire and the second most important policy domain after the second questionnaire. The individual policies perceived as most important were school-based mental health services, state mental health parity, and Medicaid reimbursement rates. Key stakeholders in CMHS should leverage this group of policies to understand the current policy landscape in their state and to identify gaps in policy domains and potential policy opportunities to create a more comprehensive system to address children's mental health from a holistic, evidence-based policymaking perspective.
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Affiliation(s)
- Katherine L Nelson
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA, 19104, USA.
| | - Byron J Powell
- Brown School and School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Brent Langellier
- Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Félice Lê-Scherban
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | | | - Kimberly Hoagwood
- Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York, USA
| | - Jonathan Purtle
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, USA
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Doupnik SK, Passarella M, Terwiesch C, Marcus SC. Mental Health Service Use Before and After a Suicidal Crisis Among Children and Adolescents in a United States National Medicaid Sample. Acad Pediatr 2021; 21:1171-1178. [PMID: 34058404 PMCID: PMC8429213 DOI: 10.1016/j.acap.2021.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/21/2021] [Accepted: 04/25/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Mental health follow-up after an emergency department (ED) visit for suicide ideation/attempt is a critical component of suicide prevention for young people. METHODS We analyzed 2009 to 2012 Medicaid Analytic EXtract for 62,139 treat-and-release ED visits and 30,312 ED-to-hospital admissions for suicide ideation/attempt among patients ages 6 to 17 years. We used mixed-effects logistic regression models to examine associations between patients' health care utilization prior to the ED visit and likelihood of completing a 30-day mental health follow-up visit. RESULTS Overall, for treat-and-release ED visits, 49% had a 30-day follow-up mental health visit, and for ED-to-hospital admissions, 67% had a 30-day follow-up mental health visit. Having a mental health visit in the 30 days preceding the ED visit was the strongest predictor of completing a mental health follow-up visit (ED treat-and-release: adjusted odds ratio [AOR] 11.01; 95% confidence interval [CI] 9.82-12.35; ED-to-hospital AOR 4.60; 95% CI 3.16-6.68). Among those with no mental health visit in the 30 days preceding the ED visit, only 25% had an ambulatory mental health follow-up visit. Having a general health care visit in the 30 days preceding the ED visit had a much smaller association with completing a mental health follow-up visit (ED treat-and-release: AOR 1.17; 95% CI 1.09-1.24; ED-to-hospital AOR 1.25; 95% CI 1.17-1.34). CONCLUSIONS Young people without an existing source of ambulatory mental health care have low rates of mental health follow-up after an ED visit for suicide ideation or attempt, and opportunities exist to improve mental health follow-up for youth with recent general health care visits.
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Affiliation(s)
- Stephanie K Doupnik
- Department of Pediatrics, Center for Pediatric Clinical Effectiveenss, and PolicyLab, Children's Hospital of Philadelphia (SK Doupnik and M Passarella), Philadelphia, Pa; The Leonard Davis Institute of Health Economics, The University of Pennsylvania (SK Doupnik, C Terwiesch, and SC Marcus), Philadelphia, Pa.
| | - Molly Passarella
- Department of Pediatrics, Center for Pediatric Clinical Effectiveenss, and PolicyLab, Children's Hospital of Philadelphia (SK Doupnik and M Passarella), Philadelphia, Pa
| | - Christian Terwiesch
- Wharton School (C Terwiesch), Philadelphia, Pa; The Leonard Davis Institute of Health Economics, The University of Pennsylvania (SK Doupnik, C Terwiesch, and SC Marcus), Philadelphia, Pa
| | - Steven C Marcus
- School of Social Policy and Practice and Center for Mental Health (SC Marcus), Philadelphia, Pa; The Leonard Davis Institute of Health Economics, The University of Pennsylvania (SK Doupnik, C Terwiesch, and SC Marcus), Philadelphia, Pa
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SCHOR EDWARDL. Developing a Structure of Essential Services for a Child and Adolescent Mental Health System. Milbank Q 2021; 99:62-90. [PMID: 33463772 PMCID: PMC7984671 DOI: 10.1111/1468-0009.12490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Policy Points That child and adolescent mental health services needs are frequently unmet has been known for many decades, yet few systemic solutions have been sought and fewer have been implemented at scale. Key among the barriers to improving child and adolescent mental health services has been the lack of well-organized primary mental health care. Such care is a mutual but uncoordinated responsibility of multiple disciplines and agencies. Achieving consensus on the essential structures and processes of mental health services is a feasible first step toward creating an organized system.
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Ardalan K, Adeyemi O, Wahezi DM, Caliendo AE, Curran ML, Neely J, Kim S, Correll CK, Brunner EJ, Knight AM. Parent Perspectives on Addressing Emotional Health for Children and Young Adults With Juvenile Myositis. Arthritis Care Res (Hoboken) 2020; 73:18-29. [PMID: 32986925 DOI: 10.1002/acr.24466] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/22/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess parent perspectives regarding the emotional health impact of juvenile myositis (JM) on patients and families, and to assess preferences for emotional health screening and interventions. METHODS Parents of children and young adults with JM were purposively sampled for participation in focus groups at the Cure JM Foundation National Family Conference in 2018. Groups were stratified by patient age group (6-12, 13-17, and 18-21 years), and conversations were audiorecorded, transcribed verbatim, and co-coded via content analysis, with subanalysis by age group. A brief survey assessed preferences for specific emotional health interventions. RESULTS Forty-five parents participated in 6 focus groups. Themes emerged within 2 domains: emotional challenges, and screening and interventions. Themes for emotional challenges comprised the impact of JM on: 1) patient emotional health, particularly depression and anxiety; 2) parent emotional health characterized by sadness, grief, anger, guilt, and anxiety; and 3) family dynamics, including significant sibling distress. Subanalysis revealed similar themes across age groups, but the theme of resiliency emerged specifically for young adults. Themes for emotional health screening and interventions indicated potential issues with patient transparency, several barriers to resources, the facilitator role of rheumatology providers, and preferred intervention modalities of online and in-person resources, with survey responses most strongly supporting child/parent counseling and peer support groups. CONCLUSION JM is associated with intense patient and family distress, although resiliency may emerge by young adulthood. Despite existing barriers, increasing access to counseling, peer support groups, and online resources with rheumatology facilitation may be effective intervention strategies.
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Affiliation(s)
- Kaveh Ardalan
- Duke University Medical Center, Durham, North Carolina, and Ann and Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Anne E Caliendo
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | - Jessica Neely
- University of California San Francisco Medical Center, San Francisco
| | - Susan Kim
- University of California San Francisco Medical Center, San Francisco
| | | | | | - Andrea M Knight
- Hospital for Sick Children and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada, and University of Pennsylvania Perelman School of Medicine, Philadelphia
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Eisenberg MD, Du S, Sen AP, Kennedy-Hendricks A, Barry CL. Health Care Spending by Enrollees With Substance Use and Mental Health Disorders in High-Deductible Health Plans vs Traditional Plans. JAMA Psychiatry 2020; 77:872-875. [PMID: 32293656 PMCID: PMC7160743 DOI: 10.1001/jamapsychiatry.2020.0342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This cross-sectional study compares health care spending among high-deductible health plan vs traditional plan enrollees with substance use and mental health disorders.
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Affiliation(s)
- Matthew D. Eisenberg
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Johns Hopkins Center for Mental Health and Addiction Policy Research, Baltimore, Maryland
| | - Shawn Du
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Aditi P. Sen
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alene Kennedy-Hendricks
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Johns Hopkins Center for Mental Health and Addiction Policy Research, Baltimore, Maryland
| | - Colleen L Barry
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,Johns Hopkins Center for Mental Health and Addiction Policy Research, Baltimore, Maryland,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Mahomed F. Addressing the Problem of Severe Underinvestment in Mental Health and Well-Being from a Human Rights Perspective. Health Hum Rights 2020; 22:35-49. [PMID: 32669787 PMCID: PMC7348439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Throughout the world, mental health remains a neglected priority, low on the agenda of policy makers and funders at the national and international levels. While this is shifting somewhat, there remains a considerable need to address the underprioritization of mental health and well-being, perhaps even more so in the wake of the COVID-19 pandemic. However, given the history of mental health interventions-which have overemphasized the biomedical model and have thus resulted in coercion, denial of life in the community, and unnecessary pathologization of human experience-there is also a need to ensure that increased funding does not simply replicate these mistakes. This is particularly true in the current landscape, where efforts to "scale up" mental health and to reduce "treatment gaps" are gaining momentum and where post-pandemic responses are still being formulated. As the potential for global mechanisms for funding mental health increases, national and international funders should look to practices that are rights affirming and contextually relevant. In this paper, I explore the current landscape of mental health financing, in terms of both national resource allocation and development assistance. I then outline the momentum in global mental health that is likely to materialize through increased funding, before considering ways in which that funding might be utilized in a manner that promotes human rights.
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Affiliation(s)
- Faraaz Mahomed
- Program Officer for Mental Health and Rights at the Open Society Foundations, New York, USA, Research Associate, Harvard Law School Project on Disability and Visiting Research Fellow at the Centre for Applied Legal Studies, University of the Witwatersrand, Johannesburg, South Africa
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Li X, Ma J. Does Mental Health Parity Encourage Mental Health Utilization Among Children and Adolescents? Evidence from the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). J Behav Health Serv Res 2019; 47:38-53. [DOI: 10.1007/s11414-019-09660-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Perrin JM. Can Mental Health Parity Help Address the Mental/Behavioral Gap in Child Health? Pediatrics 2018; 142:peds.2018-1572. [PMID: 30037973 DOI: 10.1542/peds.2018-1572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- James M Perrin
- MassGeneral Hospital for Children and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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