Future Funding For Mental Health And Substance Abuse: Increasing Burdens For The Public Sector

Levit, Katharine R.; Kassed, Cheryl A.; Coffey, Rosanna M.; Mark, Tami L.; Stranges, Elizabeth; Buck, Jeffrey A.; Vandivort-Warren, Rita

doi:10.1377/hlthaff.27.6.w513

Cited by 35 publications

(25 citation statements)

References 10 publications

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“…Our data do not allow us to directly investigate reasons for these patterns, but we can speculate. Income may be less important for receiving treatment for AUDs versus mental health disorders because the percentage of AUD treatment that is publicly funded is larger than the percentage of mental health treatment publicly funded (Levit et al, 2008). Further, some AUD treatment (e.g., self-help groups) is free to the patient.…”

Section: Discussionmentioning

confidence: 99%

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Edlund

Booth

Han

2012

J. Stud. Alcohol Drugs

100

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ABSTRACT. Objective: Only a fraction of individuals with alcohol use disorders (AUDs) receive any AUD treatment during a given year. If a substantial proportion of individuals with unmet need for AUD treatment are receiving mental health treatment, accessibility of AUD treatment could potentially be improved by implementing strategies to ensure that individuals receiving mental health care are referred to the AUD sector or by increasing rates of AUD treatment in individuals receiving mental health treatment. Method: We assessed patterns and predictors of mental health treatment and AUD treatment among individuals with 12-month AUDs, using secondary data analyses from two national surveys, the National Survey on Drug Use and Health (NSDUH; n = 4,545 individuals with AUDs) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 3,327 individuals with AUDs). Results: In both NSDUH and NESARC, 8% of individuals with AUDs reported past-year AUD treatment. Among individuals with AUDs, mental health treatment was more common than AUD treatment, with 20% of NSDUH respondents and 11% of NESARC respondents reporting receiving mental health treatment. Greater mental health morbidity increased the odds of mental health treatment, and AUD severity increased the odds of AUD treatment. Mental health morbidity also increased the odds of AUD treatment, mainly by increasing the odds of receiving the category of both AUD and mental health treatment. Conclusions: Because individuals with AUDs are more likely to receive mental health treatment than AUD treatment, a key opportunity to improve the overall accessibility of treatment for AUDs may be to focus on improving AUD treatment among individuals receiving mental health treatment. (J. Stud.

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Section: Discussionmentioning

confidence: 99%

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Edlund

Booth

Han

2012

J. Stud. Alcohol Drugs

100

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“…Projections are also likely to be significantly affected by the "imminent and serious mental health needs of returning combat veterans" and natural disasters, economic conditions, and shifting political environments. 186 The literature in this area is extensive but fragmented. For example, Fenton et al 187 compared a residential crisis treatment program with general hospital psychiatric care and found that acute treatment episode cost was $3 046 per person for the residential program compared with $5 549 for hospitalization (1995 dollars).…”

Section: Resource Acquisition and Distributionmentioning

confidence: 99%

Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

Green¹,

Estroff²,

Yarborough³

et al. 2014

Schizophrenia Bulletin

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“…The studies on funding and revenue examine substance abuse treatment generally, rather than SBI or SBIRT in particular. Recent topics include describing funding trends [8], discovering and navigating funding sources [9], setting reimbursement to be commensurate with cost bands [10], assessing the relationship between funding source and credentialing [11] and understanding the impact of managed care on treatment [12].…”

Section: Introductionmentioning

confidence: 99%

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs

et al. 2017

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Aims To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. Design A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. Setting Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists. Participants Practitioners in seven SBIRT programs who received grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA). Measurements Program costs and revenues were measured using data from grantees. Patient flows were measured from administrative data and adjusted with prevalence and screening estimates from the literature. Findings SBIRT can be sustained through health insurance reimbursement in out-patient and emergency department settings in most staffing mixes. To sustain SBIRT in in-patient programs, a patient flow larger than the national average may be needed; if that flow is achieved, the range of screens required to maintain a surplus is narrow. Sensitivity analyses suggest that the results are very sensitive to changes in the proportion of insured patients. Conclusions Screening, Brief Intervention and Referral to Treatment programs in the United States can be sustained by health insurance payments under a variety of staffing models. Screening, Brief Intervention and Referral to Treatment programs can be sustained only in an in-patient setting with above-average patient flow (more than 2500 screens). Screening, Brief Intervention and Referral to Treatment programs in out-patient and emergency department settings can be sustained with below-average patient flows (fewer than 125 000 out-patient visits and fewer than 27 000 emergency department visits).

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Future Funding For Mental Health And Substance Abuse: Increasing Burdens For The Public Sector

Cited by 35 publications

References 10 publications

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Who Seeks Care Where? Utilization of Mental Health and Substance Use Disorder Treatment in Two National Samples of Individuals with Alcohol Use Disorders

Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs

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