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APHA Scientific Session and Event Listing

Colleen L. Barry, PhD, Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street #302, New Haven, CT 06520, 203-785-4956, colleen.barry@yale.edu and Susan H. Busch, PhD, Department of Epilemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06520.

State mental health parity laws require private insurers to provide equivalent coverage for mental health and general medical care. Previous research suggests these laws have minimally affected outcomes among individuals with mental disorders. Data limitations in prior studies prevented careful assessment of effects among those with severe mental disorders. We study the effects of parity on Children with Special Health Care Needs (CSHCN). Children with severe mental illnesses are often privately insured under a parental policy and may benefit substantially from insurance expansion. We examine whether state parity laws reduce the economic burden on families and increase the probability that a child receives needed mental health care. We use instrumental variable estimation controlling for detailed information on a child's health and functional impairment. We compare those in parity and non-parity states and those needing mental health care with other children. Data come from the nationally representative 2000 SLAITS CSHCN Survey (N=38,856).

Multivariate regression results indicate that living in a parity state significantly reduced the financial burden on families of children with mental health care needs. Specifically, we detect significantly lower out-of-pocket health care spending among families with children needing mental health care living in parity states compared with those in non-parity states. Families with children needing mental health care in parity states were also more likely to view these out-of-pocket charges as reasonable compared with those in non-parity states. We detect no significant difference among residents of parity and non-parity states in receipt of needed mental health care.

Learning Objectives:

• Evaluate the effects of state parity laws on children with mental health care needs.
• Assess whether the enactment of state parity legislation leads to measurable clinical and economic benefits for children with serious mental health disorders.
• Consider policy alternatives for expanding access to services and increasing financial protection for this vulnerable population.

Keywords: Mental Health, Insurance

Presenting author's disclosure statement:

Any relevant financial relationships? No