A systematic review of the effectiveness of mental health benefits legislation to improve mental health

Background: Mental health benefits legislation is intended to improve access to and use of mental health services and improve financial protection by changing regulations for mental health coverage. This presentation describes the methods and the results of the systematic review on effectiveness of mental health benefits legislation in improving mental health.

Methods: The Guide to Community Preventive Services' methods for systematic reviews were used to analyze available evidence on the effectiveness of mental health benefits legislation, including executive orders.

We searched for studies from 1965 - March 2011. Over 15,000 citations were screened; 30 eligible quasi-experimental and observational studies identified in 37 papers met the inclusion criteria for the reviews.

Results: Evidence indicates that mental health benefits legislation is effective in 1) reducing suicides, 2) increasing any utilization for populations identified with a mental health need, 3) increasing quality of care for populations identified with a mental health need 4) increasing outpatient utilization, 5) improving quality of care, 6) reducing morbidity (percentage in poor mental health), 7) and improving diagnosis of mental health conditions. Furthermore, evidence suggests that comprehensive parity legislation tends to be more effective than limited legislation. Mental health benefits legislation is also effective in increasing access to mental health services and financial protection by reducing out of pocket costs for users of mental health services.

Conclusion: Mental health benefits legislation is effective in improving mental health in many outcomes. This scientific evidence can assist policy makers in future decision-making and implementation of mental health benefits legislation.