The 130th Annual Meeting of APHA

4057.0: Tuesday, November 12, 2002 - 9:30 AM

Abstract #47591

Access to mental health care: SCHIP versus Medicaid

Pamela Owens, PhD1, Susan DosReis, PhD2, David Michalik3, Paula Hibbert3, Nancy Widdoes4, and Philip Leaf, PhD5. (1) Center for Organization and Delivery Studies, Agency for Healthcare Research and Quality, 2101 East Jefferson Street, Suite 605, Rockville, MD 20852, 301-594-0759, powens@ahrq.gov, (2) Division of Child and Adolescent Psychiatry, Johns Hopkins Medical Institutions, 600 N. Wolfe Street, CMSC 346, Baltimore, MD 21287, (3) Division of Social Services, State Medicaid Administration, (4) Division of Child Mental Health Services, State Department of Services for Children, Youth and Their Families, (5) Hopkins Center for the Prevention of Youth Violence, Johns Hopkins School of Public Health, 624 North Broadway, Baltimore, MD 21205

Background: Little is known about the impact of the State Children’s Health Insurance Program (SCHIP) on mental health (MH) utilization, despite the fact that many children suffer from a mental illness and do not receive services because they lack insurance.

Objective: To examine the prevalence of MH service utilization before and after implementation of SCHIP, and to determine whether MH service utilization varied by type of enrollment.

Methods: Data were derived from two years (1998-1999) of Medicaid and SCHIP claims and eligibility files in one Mid-Atlantic state. The prevalence of MH diagnoses (attention-deficit/hyperactivity disorder [ADHD], depression) and service utilization among children aged <20 were compared between 1998 and 1999. Comparisons also were made across three enrollment groups in 1999: Medicaid only, SCHIP only, and Medicaid/SCHIP.

Results: The prevalence of MH services was 8.2% for Medicaid-enrolled children in 1998 and, in 1999 it was 8.3% for Medicaid only, 6.1% for Medicaid/SCHIP, and 2.3% for SCHIP only. In 1998 and 1999, respectively, the prevalence of ADHD was 3.6% and 3.3% and the prevalence of depression was 0.95% and 1%. The prevalence of MH services for ADHD in 1998 was 1.7% in Medicaid, and in 1999 it was 1.8%, 1.5%, and 0.95%, respectively, for Medicaid only, Medicaid/SCHIP, and SCHIP only enrolled youths. The 1999 prevalence of MH services for depression was 0.8% (Medicaid only), 0.9% (Medicaid/SCHIP), and 0.5% (SCHIP), compared to 0.7% for Medicaid-enrolled children in 1998.

Conclusions: SCHIP has the potential to address concerns regarding children’s access to mental health services.

Learning Objectives: At the conclusion of the session, the participant will be able to

Keywords: Access to Care, Child/Adolescent Mental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Children's Mental Health Services

The 130th Annual Meeting of APHA