Perceived Impact by Administrators of Psychiatric Emergency Services after Changes in a State’s Mental Health System

Abstract

As a safety net, psychiatric emergency services are sensitive to system changes. To determine the impact of a state's changes in its mental health system, administrators of publicly funded psychiatric emergency services were surveyed. They reported few (M=0.8) negative changes in coordination of care but 77% endorsed change in administrative burden (54% saying it negatively affected quality of services). Reporting negative effect of administrative burden was associated with treating more persons with substance abuse problems and greater challenge posed by distance to local providers. These results suggest that impact of state-level changes was not uniform but associated with local characteristics.

Implementation of Massachusetts Health Insurance Reform with Vulnerable Populations in a Safety-Net Setting

“…11–14 Racial and ethnic minorities in general, and immigrants in particular, have been found to have high rates of uninsurance compared with the U.S.-born non-Latino White population, 15,16 due to a combination of linguistic barriers, citizenship status, and employment status (e.g., whether employers offer insurance for part-time workers). 15,17 For people with mental health disorders, too, significant outreach efforts may be necessary from institutions and care providers in order to avoid disruptions in care.…”