Health insurance laws may be key to ensuring children get the care they need.
By reviewing data from nearly 30,000 caregivers across the U.S., a recent study led by researchers at the University of California, San Francisco (UCSF) and published in JAMA Network Open, found that children in states with well-defined mental health insurance coverage laws are much more likely to access necessary care what it’s needed. Therefore, when comprehensive regulations are in place, children are more often address common issues like anxiety, depression, and suicidal thoughts, potentially saving lives.
Adolescent rates of anxiety, depression, and suicide have reached alarming levels in recent years, becoming a significant public health concern. Studies show that nearly one in three adolescents will experience an anxiety disorder by the age of 18, with rates of depression also on the rise, affecting about 15% of teens. These challenges are closely linked to an increase in suicide rates, which have more than doubled among youth aged 10-24 over the past decade, making suicide the second leading cause of death in this age group.
Dr. Ashley Foster, a pediatric emergency care physician at UCSF Benioff Children’s Hospital San Francisco and the study’s first author, said, “Unfortunately, in my own practice, I regularly see children who are unable to access needed mental health care, and their symptoms continue to worsen until they reach a crisis point.”
Between 2016 and 2019, approximately 1 in 8 caregivers reported difficulty accessing mental health services for their children. However, the study revealed that caregivers living in states with the most comprehensive mental and behavioral health coverage laws were about 20% less likely to experience these challenges compared to those in states with less robust laws.
The authors concluded, “In this study, living in states with the most comprehensive [mental and behavioral health] insurance legislation was associated with lower odds of perceived poor access to MBH care among caregivers for children and adolescents with MBH conditions. This finding suggests that advocacy for comprehensive mental health parity legislation may promote improved child and adolescent access to MBH services.”
This highlights the importance of legislative measures in overcoming barriers to mental health services, which is especially crucial given the growing mental health crisis among young people. Even when families have insurance coverage, mental and behavioral health providers may refuse to accept certain types of insurance or may not accept insurance at all, creating additional hurdles for families seeking care. Moreover, high co-pays or deductibles can further deter families from pursuing necessary treatment, even when coverage is technically available.
The study also highlights disparities in access to mental health care among different demographic groups. Caregivers of Black and Asian children were more likely to report difficulties in accessing services, as were those whose children had experienced more adverse childhood events (ACEs). These findings suggest that systemic inequities in mental health care access persist, and that comprehensive mental health coverage laws alone may not be sufficient to address these disparities.
To address these challenges, the study’s authors advocate for a multifaceted approach that includes strengthening community-based mental health services, developing a culturally diverse workforce that reflects the population it serves, and expanding reimbursement for telehealth services. They also recommend that states clearly define which mental health disorders must be covered by insurance, with conditions such as autism and attention-deficit hyperactivity disorder (ADHD) being prioritized.
Sources:
Comprehensiveness of State Insurance Laws and Perceived Access to Pediatric Mental Health Care
Comprehensive mental health coverage laws improve children’s access to care, study reveals
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