Impact of withdrawing public mental health benefits from non-Medicaid patients in Southern Arizona

On average, US public mental health patients lose over 25 years of potential life. However, in Arizona, the average life expectancy of public mental health benefit recipients is nearly 32 years shorter than the general population. Effective July 1, 2010, Arizona cut nearly all services, except medication monitoring, a generic medication formulary, and crisis services, for approximately 17,600 mentally ill patients not receiving Medicaid, representing half of the seriously mentally ill population in Arizona. Conversely, Medicaid patients receiving mental health benefits retained their benefits including access to brand-name medications, therapy and wrap around services, including transportation and case management. The purpose of this study was to assess the impact of these cuts on the number of emergency room visits, number of inpatient psychiatric hospitalizations, length of inpatient stay, and total costs of service for both Medicaid recipients and non-recipients designated as seriously mentally ill at one of the largest acute care psychiatric facilities in the state. Using a retrospective chart review, all adults between 18-55 years old, with a primary qualifying mental illness diagnosis and a date of admission during one of two 6-month time periods: Oct. 1, 2009-March 31, 2010 and Oct. 1, 2010-March 31, 2011 were examined to assess the impact of benefit cuts. Additionally, differences between racial and ethnic minority groups and rural populations were examined for each time period. The significance of these results will support the creation of public policies that balance limited budget savings when reducing public mental health benefits for already under-served populations.