Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act

Novak, Priscilla; Anderson, A. C.; Chen, Jie

doi:10.1007/s10488-018-0875-9

Cited by 26 publications

(9 citation statements)

References 28 publications

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“…Regarding health insurance, some work suggests people with private insurance, rather than publicly assisted insurance, are more likely to complete SUD treatment (Mutter, Ali, Smith, & Strashny, 2015). Regarding health insurance generally, according to one study, rates of coverage have recently increased while delaying and forgoing mental health care, as well as being unable to afford it, has reduced (Novak, Anderson, & Chen, 2018). Other research finds health coverage to be a barrier to mental health care in a variety of ways (e.g., insurance not covering mental health services, patient confusion regarding mental health coverage; Eisenberg, Golberstein, & Gollust, 2007).…”

Section: Resource Support Characteristicsmentioning

confidence: 99%

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

Baker¹,

Edmonds²,

Calvert³

et al. 2020

Psychological Services

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Although numerous factors are associated with attrition in substance use disorder (SUD) treatment, many are unmodifiable and therefore difficult to target in efforts to improve treatment outcomes. The current study sought to identify the strongest and most modifiable predictors of attrition in long-term residential SUD treatment from myriad characteristics associated with treatment termination. Archival data were examined for 2,069 adults (74% male; 38% non-Hispanic White) who entered a long-term residential SUD treatment facility between January 2010 and June 2016. Program staff recorded clients’ demographic, situational, substance use, and intake data at admission; discharge data were recorded at termination. To increase the likelihood our results were clinically meaningful, we randomly split our sample, ran 2 5-step hierarchical logistic regressions, and cross-validated our results. Across samples, we found younger age, having less than a high school education (Step 1), unstable living arrangements (Step 2), greater prior month use of primary substances, less prior month use of alcohol, and prior year needle use preceding treatment (Step 4), and longer recommended length of stay in treatment (Step 5) predicted attrition. To improve long-term residential SUD treatment completion, we propose treatment adaptations begin with the most modifiable predictors of attrition. Accordingly, the current data indicate initial focus should be placed on refurbishing the process through which recommended treatment durations are approached by providers. Subsequent focus should be placed on modifiable factors that present greater systemic challenges, followed by those that are unmodifiable but can be indirectly targeted by interventions tailored to specific underrepresented groups.

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Section: Resource Support Characteristicsmentioning

confidence: 99%

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

Baker¹,

Edmonds²,

Calvert³

et al. 2020

Psychological Services

View full text Add to dashboard Cite

show abstract

“…22 Research on services utilization among U.S. adults with SPD suggests that the ACA increased needed mental health service utilization. 23,24 Furthermore, having health insurance may decrease anxiety among low-income urban women. 25 The literature suggests that individuals with SPD have higher utilization of physical health care services than those without SPD, 14,15,26 and this includes higher numbers of emergency department visits 27 and poorer health outcomes after surgery.…”

Section: Introductionmentioning

confidence: 99%

Disparities in Medical Debt Among U.S. Adults with Serious Psychological Distress

2020

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“…Inequality in mental health care access among racially and ethnically minoritized (1, 2) (e.g., Black and Hispanic/Latino) and low-income (e.g., access to free/reduced cost school lunch) youth is well-documented (3)(4)(5)(6)(7)(8)(9)(10)(11). Racially and ethnically minoritized low-income youth face multiple challenges from discrimination to unequal access to relevant and effective mental health services, including programs that promote positive mental health-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth

Kaar

Bowen

Simon

et al. 2023

Front. Public Health

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BackgroundAdolescents from historically racial and ethnic minoritized and low-income communities have higher rates of early-life and chronic difficulties with anxiety and depression compared to non-Hispanic White youth. With mental health distress exacerbated during and in the wake of the COVID-19 pandemic, there is a need for accessible, equitable evidence-based programs that promote psychological well-being, strengthen one’s ability to adapt to adversity, and build self-efficacy prior to adolescence.MethodsAn evidenced-based resiliency-focused health coaching intervention was adapted using a health equity implementation framework to meet the needs of a Title I elementary school in rural Alabama (AL) that serves over 80% Black and Hispanic students. To ensure that the program met local community needs while maintaining core program educational activities, all adaptations were documented utilizing a standard coding system.ResultsLeveraging an existing academic-community partnership with Auburn University and a local AL school district, a new program, Advocates 4-All Youth (ALLY), was created. Three major adaptations were required: (1) the use of local community volunteers (ALLYs) to deliver the program versus health coaches, (2) the modification of program materials to meet the challenge of varying levels of general and health-related literacy, and (3) the integration of the Empower Action Model to target protective factors in a culturally-tailored delivery to ensure key program outcomes are found equitable for all students.ConclusionWith continued increases in youth mental health distress, there is a need for the development of universal primary prevention interventions to promote mental well-being and to strengthen protective factors among youth from historically disadvantaged backgrounds. ALLY was created to meet these needs and may be an effective strategy if deemed efficacious in improving program outcomes.

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Changes in Health Insurance Coverage and Barriers to Health Care Access Among Individuals with Serious Psychological Distress Following the Affordable Care Act

Cited by 26 publications

References 28 publications

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

Disparities in Medical Debt Among U.S. Adults with Serious Psychological Distress

A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth

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