Impact of Reimbursement Systems on Child Psychiatrists: A Comparison of Canada and the United States

Newell, Audrey R.; Saltzman, Gregory M.

doi:10.1097/00004583-199510000-00018

Cited by 6 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the Canadian system, no limits are placed on access to physicians (that is, limits placed by payments for services rendered), although access to other types of mental health professionals is more constrained. Some reports also suggest that Canadian patients experience longer waits for mental health specialist services than do US patients (18). Our study provides the first report of a range of self-reported barriers to MHSU in Canada.…”

Section: Self-reported Barriers To Mental Health Service Usementioning

confidence: 61%

Mental Health Service Use in a Nationally Representative Canadian Survey

et al. 2005

View full text Add to dashboard Cite

Background: Previous Canadian surveys have noted a wide range of prevalence rates for mental health service use and found no consistent relation between type of contact with mental health professionals and severity of illness. This study is the first investigation to examine the prevalence and correlates of mental health service use in a nationally representative Canadian survey. Methods: The Canadian Community Health Survey Cycle 1.1 was conducted between 2000 and 2001 ( n = 125 493; respondent age 12 years and over; response rate; 84.7%). Respondents were asked whether they had contacted a professional because of emotional symptoms in the past year and about their experience of barriers to treatment. DSM-IV major depression and alcohol dependence diagnoses were assessed with the Composite International Diagnostic Interview Short Form. The relation between a range of measures of clinical severity and the type of professional contacted for emotional symptoms was examined. Results: The prevalence of 12-month help seeking for emotional symptoms was 8.3% (99%CI, 8.10 to 8.55); an additional 0.6% (99%CI, 0.49 to 0.62) of the sample perceived a need for treatment without seeking care. Respondents endorsing contact with multiple professionals or with psychiatrists only had higher levels of severity than those who had contact with family doctors only or nonphysician professionals only. Conclusions: Although untreated depression remains a significant problem in Canada, more severe illness was more likely to be associated with seeing a psychiatrist (or multiple professionals), indicating a relation between greater severity of mental illness and receiving more specialized care.

show abstract

Section: Self-reported Barriers To Mental Health Service Usementioning

confidence: 61%

Mental Health Service Use in a Nationally Representative Canadian Survey

et al. 2005

View full text Add to dashboard Cite

show abstract

“…If the clinician does not follow the DSM criteria based on youth or parent reports of symptoms, other factors must influence the clinical diagnosis. Possible extraneous influences include: a) group dynamics in the Demonstration treatment teams; b) treatment options, which differed between the Demonstration and Comparison sites; c) reimbursement policies; and d) social desirability (Gasquoine, 2010;Gibelman & Mason, 2002;Mullins-Sweatt & Widiger, 2009;Newell & Saltzman, 1995;Rost et al, 1994;Setterberg et al, 1991). In a survey of 460 child psychiatrists, 55% reported using adjustment disorder diagnoses to avoid more stigmatizing diagnoses (Setterberg et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

Problems in Using Diagnosis in Child and Adolescent Mental Health Services Research

Bickman

Wighton²,

Lambert

et al. 2012

JMMSS

View full text Add to dashboard Cite

This paper presents results from a three-part study on diagnosis of children with affective and behavior disorders. We examined the reliability, discriminant, and predictive validity of common diagnoses used in mental health services research using a research diagnostic interview. Results suggest four problems: a) some diagnoses demonstrate internal consistency only slightly better than symptoms chosen at random; b) diagnosis did not add appreciably to a brief global functioning screen in predicting service use; c) low inter-rater reliability among informants and clinicians for six of the most common diagnoses; and d) clinician diagnoses differed between sites in ways that reflect different reimbursement strategies. The study concludes that clinicians and researchers should not assume diagnosis is a useful measure of child and adolescent problems and outcomes until there is more evidence supporting the validity of diagnosis.DOI:10.2458/azu_jmmss_v3i1_bickman

show abstract

“…If the clinician does not follow the DSM criteria based on youth or parent reports of symptoms, other factors must influence the clinical diagnosis. Possible extraneous influences include: a) group dynamics in the Demonstration treatment teams; b) treatment options, which differed between the Demonstration and Comparison sites; c) reimbursement policies; and d) social desirability (Gasquoine, 2010;Gibelman & Mason, 2002;MullinsSweatt & Widiger, 2009;Newell & Saltzman, 1995;Rost et al, 1994;Setterberg et al, 1991). In a survey of 460 child psychiatrists, 55% reported using adjustment disorder diagnoses to avoid more stigmatizing diagnoses (Setterberg et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

Problems in Using Diagnosis in Child and Adolescent Mental Health Services Research

Bickman

Wighton

Lambert

et al. 2012

Journal of Methods and Measurement in the Social Sciences

View full text Add to dashboard Cite

This paper presents results from a three-part study on diagnosis of children with affective and behavior disorders. We examined the reliability, discriminant, and predictive validity of common diagnoses used in mental health services research using a research diagnostic interview. Results suggest four problems: a) some diagnoses demonstrate internal consistency only slightly better than symptoms chosen at random; b) diagnosis did not add appreciably to a brief global functioning screen in predicting service use; c) low interrater reliability among informants and clinicians for six of the most common diagnoses; and d) clinician diagnoses differed between sites in ways that reflect different reimbursement strategies. The study concludes that clinicians and researchers should not assume diagnosis is a useful measure of child and adolescent problems and outcomes until there is more evidence supporting the validity of diagnosis.

show abstract

Impact of Reimbursement Systems on Child Psychiatrists: A Comparison of Canada and the United States

Cited by 6 publications

References 13 publications

Mental Health Service Use in a Nationally Representative Canadian Survey

Mental Health Service Use in a Nationally Representative Canadian Survey

Problems in Using Diagnosis in Child and Adolescent Mental Health Services Research

Problems in Using Diagnosis in Child and Adolescent Mental Health Services Research

Contact Info

Product

Resources

About