scholarly journals Effects of The Mental Health Parity and Addictions Equality Act on Depression Treatment Choice in Primary Care Facilities in The United States

2016 ◽  
Vol 19 (7) ◽  
pp. A635
Author(s):  
D Goldberg ◽  
H Lin
Keyword(s):  
Mental Health ◽  
United States ◽  
Primary Care ◽  
The United States ◽  
Treatment Choice ◽  
Depression Treatment ◽  
Mental Health Parity ◽  
Care Facilities

Effects of the mental health parity and addictions equality act on depression treatment choice in primary care facilities

2017 ◽  
Vol 52 (1) ◽  
pp. 34-47 ◽  
Author(s):  
Daniel M. Goldberg ◽  
Hsien-Chang Lin
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
The United States ◽  
Depression Treatment ◽  
Mental Health Parity ◽  
Care Providers ◽  
Multinomial Regression ◽  
Care Facilities

Objective The Mental Health Parity and Addictions Equality Act (MHPAEA) of 2010 in the United States sought to expand mental health insurance benefits on par with medical benefits. As primary care facilities are often the first step in identifying mental health concerns, it is essential to examine the association of this policy with primary care physicians’ choice on depression treatment. Method A retrospective cross-sectional study was conducted using data from the 2007–2012 National Ambulatory Medical Care Survey, including a weighted total of 162,699,930 depression patients. Using the Heckman two-step selection procedure, a logistic and a multinomial regression were conducted to examine the association of the MHPAEA with physicians’ two-step process of deciding whether and which type of treatment was prescribed. Sociological factors were controlled. Results Treatment was significantly more likely to be provided after the MHPAEA. Psychotherapy was used for treatment for 10.0% of the sample while medication was used for 75.0% of the sample. Patient race/ethnicity, practice setting, physician specialty, and primary source of payment were associated with diverging likelihood of being prescribed depression treatment. Non-Hispanic White patients were more likely to be provided treatment than non-Hispanic Black patients. Patients were less likely to be prescribed only medication than only psychotherapy after the MHPAEA enactment. Conclusions The MHPAEA was associated with primary care providers’ decision and choice on depression treatment. Educational and policy interventions aimed at improving physician’s understanding of their own treatment tendencies and decreasing barriers to depression treatment may impact the disparities in underserved, minority, and older populations.

Mental Health and Substance Use Disorder Benefits Parity

2018 ◽  
Vol 50 (2) ◽  
pp. 95-106
Author(s):  
John G. Kilgour
Keyword(s):  
Mental Health ◽  
United States ◽  
Affordable Care Act ◽  
The United States ◽  
Health Plans ◽  
Mental Health Parity ◽  
Insurance Contracts ◽  
Substance Abuse Disorders ◽  
The Affordable Care Act ◽  
Trump Administration

Traditionally mental health and substance abuse disorders have been treated less generously than medical/surgical benefits in employment-provided health plans and health insurance contracts. That changed with the Mental Health Parity and Addiction Equity Act of 2008 as amended and extended by the Affordable Care Act of 2010 (Obamacare). It has been found that parity has not added significantly to health plan cost. The parity concept now applies to health plans and insurance contracts throughout the United States. This article examines that legislative development and the attending regulations and enforcement efforts. The Trump administration has vowed to repeal the Affordable Care Act, and it has already weakened it. If it succeeds, it will also weaken the Mental Health Parity and Addiction Equity Act and its parity requirements. That would be regrettable requirements.

Perceived Discrimination, Experiential Avoidance, and Mental Health among Hispanic Adults in Primary Care

2022 ◽  
pp. 136346152110381
Author(s):  
Michael J. Zvolensky ◽  
Andrew H. Rogers ◽  
Nubia A. Mayorga ◽  
Justin M. Shepherd ◽  
Jafar Bakhshaie ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Primary Care ◽  
Racial Discrimination ◽  
Experiential Avoidance ◽  
Minority Group ◽  
The United States ◽  
Hispanic Population ◽  
Hispanic Adults ◽  
Perceived Racial Discrimination

The Hispanic population is the largest minority group in the United States and frequently experiences racial discrimination and mental health difficulties. Prior work suggests that perceived racial discrimination is a significant risk factor for poorer mental health among Hispanic in the United States. However, little work has investigated how perceived racial discrimination relates to anxiety and depression among Hispanic adults. Thus, the current study evaluated the explanatory role of experiential avoidance in the relation between perceived racial discrimination and anxiety/depressive symptoms and disorders among Hispanic adults in primary care. Participants included 202 Spanish-speaking adults ( Mage = 38.99, SD = 12.43, 86.1% female) attending a community-based Federally Qualified Health Center. Results were consistent with the hypothesis that perceived racial discrimination had a significant indirect effect on depression, social anxiety, and anxious arousal symptoms as well as the number of mood and anxiety disorders through experiential avoidance. These findings suggest future work should continue to explore experiential avoidance in the association between perceived racial discrimination and other psychiatric and medical problems among the Hispanic population.

How Do Primary Care Clinicians Manage Childhood Mood and Anxiety Syndromes?

2005 ◽  
Vol 35 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Frances J. Wren ◽  
Sarah H. Scholle ◽  
Jungeun Heo ◽  
Diane M. Comer
Keyword(s):  
Mental Health ◽  
United States ◽  
Primary Care ◽  
Puerto Rico ◽  
Care Management ◽  
Psychosocial Problems ◽  
The United States ◽  
Primary Care Clinicians ◽  
Primary Care Management

Objective: To describe how primary care clinicians manage children in whom they diagnose mood or anxiety syndromes. Method: This study is a secondary analysis of data from the multi-site Child Behavior Study (CBS)—a cross-sectional survey of primary care management of psychosocial problems. The management of children in whom clinicians identified mood or anxiety syndromes is described and compared with the management of children in whom they identified other psychosocial problems. Recruitment for the CBS occurred in 206 primary care practices in the United States, Puerto Rico, and Canada from October 1994 through June 1997. Participants were 20,861 consecutively sampled primary care attendees aged 4–15 years and 395 clinicians. Primary outcome measures for this report are rates of referral to specialized mental health care and rates of active primary care management (i.e., scheduling a follow-up appointment and/or providing ongoing counseling and/or psychotropic prescription). Results: Identification of a mood or anxiety syndrome was associated with increased rates of referral to mental health compared with rates for children with other psychosocial problems. There was no effect on the proportion of children counseled during the visit. In fact, unless accompanied by a co-morbid behavioral syndrome, children receiving the diagnosis of a mood or anxiety syndrome were less likely to be offered a scheduled follow-up appointment. Rates of prescription of antidepressants or anti-anxiety agents were higher for mood/anxiety groups but this was still uncommon (6.7%). Conclusions: Active management of childhood mood and anxiety syndromes in primary care was uncommon in the United States, Puerto Rico, and Canada in the mid-1990s.

Do Minorities in the United States Receive Fewer Mental Health Services Than Whites?

2002 ◽  
Vol 32 (3) ◽  
pp. 567-578 ◽  
Author(s):  
Karen E. Lasser ◽  
David U. Himmelstein ◽  
Steffie J. Woolhandler ◽  
Danny McCormick ◽  
David H. Bor
Keyword(s):  
Mental Health ◽  
United States ◽  
Primary Care ◽  
Drug Therapy ◽  
The United States ◽  
Mental Health Counseling ◽  
Health Counseling ◽  
Outpatient Mental Health ◽  
Care Survey ◽  
Ambulatory Medical Care

Older studies have found that minorities in the United States receive fewer mental health services than whites. This analysis compares rates of outpatient mental health treatment according to race and ethnicity using more recent, population-based data, from the 1997 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. The authors calculated visit rates per 1,000 population to either primary care or psychiatric providers for mental health counseling, psychotherapy, and psychiatric drug therapy. In the primary care setting, Hispanics and blacks had lower visit rates (per 1,000 population) for drug therapy than whites (48.3 and 73.7 vs. 109.0; P < .0001 and P < .01, respectively). Blacks also had a lower visit rate for talk therapy (mental health counseling or psychotherapy) than whites (23.6 vs. 42.5; P < .01). In the psychiatric setting, Hispanics and blacks had lower visit rates than whites for talk therapy (38.4 and 33.6 vs. 85.1; P < .0001 for both comparisons) and drug therapy (38.3 and 29.1 vs. 71.8; P < .0001 for both comparisons). These results indicate that minorities receive about half as much outpatient mental health care as whites.

Mental health services providers' distribution across counties in the United States.

1984 ◽  
Vol 39 (12) ◽  
pp. 1424-1434 ◽  
Author(s):  
David J. Knesper ◽  
John R. Wheeler ◽  
David J. Pagnucco
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Health Services ◽  
Health Services ◽  
The United States
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