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Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-09-2019 | Care | Original Article

Rapid Growth of Mental Health Services at Community Health Centers

Authors: Tim A. Bruckner, Parvati Singh, Lonnie R. Snowden, Jangho Yoon, Bharath Chakravarthy

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 5/2019

Abstract

Community Health Centers (CHCs) target medically underserved communities and expanded by 70% in the last decade. We know little, however, about mental health services at CHCs. We analyzed data from 2006 to 2015 and determined county-level drivers of these services. Mental health patients at CHCs fall from 2006 to 2007 but then rise consistently from 2007 to 2015. Counties with fewer physicians, greater percent insured and greater percent white population show faster growth in mental health services. Increases in mental health services at CHCs outpace general CHC growth and reflect federal efforts to integrate behavioral health care into primary care.

Allard, S. W., Tolman, R. M., & Rosen, D. (2003). Proximity to service providers and service utilization among welfare recipients: The interaction of place and race. Journal of Policy Analysis and Management, 22(4), 599–613. https://doi.org/10.1002/pam.10157.CrossRefPubMed

Andrilla, C. H. A., Patterson, D. G., Garberson, L. A., Coulthard, C., & Larson, E. H. (2018). Geographic variation in the supply of selected behavioral health providers. American Journal of Preventive Medicine, 54(6), S199–S207.CrossRefPubMed

Area Health Resource Files (AHRF). (2018). County level data. Health Resources & Services Administration. Retrieved from https://data.hrsa.gov/data/download.

Bower, P., Kontopantelis, E., Sutton, A., Kendrick, T., Richards, D. A., Gilbody, S.,… & Meyer, B. (2013). Influence of initial severity of depression on effectiveness of low intensity interventions: Meta-analysis of individual patient data. BMJ, 346, f540.

Bruckner, T. A., Singh, P., Yoon, J., Chakravarthy, B., & Snowden, L. (2019). Psychiatric emergency department visits after regional expansion of Community Health Centers. Psychiatric Services. https://doi.org/10.1176/appi.ps.201800553.

Buchmueller, T. C., Levinson, Z. M., Levy, H. G., & Wolfe, B. L. (2016). Effect of the affordable care act on racial and ethnic disparities in health insurance coverage. American Journal of Public Health, 106(8), 1416–1421.CrossRefPubMedPubMedCentral

Bureau of Primary Health Care. (2012). UDS Reporting Instructions for Health Centers. Retrieved from https://bphc.hrsa.gov/datareporting/reporting/2012udsmanual.pdf.

Busch, S. H. (2012). Implications of the Mental Health Parity and Addiction Equity Act. The American Journal of Psychiatry, 169(1), 1–3. https://doi.org/10.1176/appi.ajp.2011.11101543.CrossRefPubMedPubMedCentral

Consolidated Health Centers Act. (2018). Section 330 of the Public Health Service Act. Retrieved from http://www.nachc.org/wp-content/uploads/2018/05/Section-330-statute-as-of-March-2018-Clean.pdf.

Cook, B. L., Zuvekas, S. H., Chen, J., Progovac, A., & Lincoln, A. K. (2017). Assessing the individual, neighborhood, and policy predictors of disparities in mental health care. Medical Care Research and Review, 74(4), 404–430.CrossRefPubMed

Croft, B., & Parish, S. L. (2013). Care integration in the Patient Protection and Affordable Care Act: Implications for behavioral health. Administration and Policy In Mental Health, 40(4), 258–263. https://doi.org/10.1007/s10488-012-0405-0.CrossRefPubMed

Druss, B. G., Bornemann, T., Fry-Johnson, Y. W., McCombs, H. G., Politzer, R. M., & Rust, G. (2006). Trends in mental health and substance abuse services at the Nation’s Community Health Centers: 1998–2003. American Journal of Public Health, 96(10), 1779–1784.CrossRefPubMedPubMedCentral

Fortney, J., Rost, K., Zhang, M., & Warren, J. (1999). The impact of geographic accessibility on the intensity and quality of depression treatment. Medical Care, 37(9), 884–893.CrossRefPubMed

Frank, R. G., Beronio, K., & Glied, S. A. (2014). Behavioral health parity and the Affordable Care Act. Journal of Social Work in Disability & Rehabilitation, 13(1–2), 31–43. https://doi.org/10.1080/1536710X.2013.870512.CrossRef

Garfield, R. L., Zuvekas, S. H., Lave, J. R., & Donohue, J. M. (2011). The impact of national health care reform on adults with severe mental disorders. American Journal of Psychiatry, 168(5), 486–494. https://doi.org/10.1176/appi.ajp.2010.10060792.CrossRefPubMed

Goldman, L. E., Chu, P. W., Tran, H., Romano, M. J., & Stafford, R. S. (2012). Federally qualified health centers and private practice performance on ambulatory care measures. American Journal of Preventive Medicine, 43(2), 142–149. https://doi.org/10.1016/j.amepre.2012.02.033.CrossRefPubMedPubMedCentral

Health Resources & Services Administration (HRSA). (2010). Table 4: Selected patient characteristics. 2010 National Data. Retrieved from https://bphc.hrsa.gov/uds/socioeconomic.aspx?year=2010&state=.

Health Resources & Services Administration (HRSA). (2014). HRSA awards $51.3 million in Affordable Care Act funding to support mental health and substance abuse treatment. Retrieved from https://www.hrsa.gov/about/news/press-releases/2014-11-06-behavioral-health.html.

Health Resources & Services Administration (HRSA). (2018a). Health center data & reporting. Retrieved from https://bphc.hrsa.gov/datareporting/index.html.

Health Resources & Services Administration (HRSA). (2018b). Behavioral health and primary care integration. Retrieved from https://bphc.hrsa.gov/qualityimprovement/clinicalquality/behavioralhealth/index.html.

Health Resources & Services Administration (HRSA). (2018c). Uniform data system (UDS) Resources. Retrieved from https://bphc.hrsa.gov/datareporting/reporting/index.html.

Kaiser Family foundation. (2012). States getting a jump start on health reform’s medicaid expansion. Retrieved from https://www.kff.org/health-reform/issue-brief/states-getting-a-jump-start-on-health/.

Kegler, S. R., Stone, D. M., & Holland, K. M. (2017). Trends in suicide by level of urbanization—United States, 1999–2015. Morbidity and Mortality Weekly Report, 66(10), 270.CrossRefPubMedPubMedCentral

Ko, M., & Ponce, N. A. (2013). Community residential segregation and the local supply of federally qualified health centers. Health Services Research, 48(1), 253–270. https://doi.org/10.1111/j.1475-6773.2012.01444.x.CrossRefPubMed

Laiteerapong, N., Kirby, J., Gao, Y., Yu, T. C., Sharma, R., Nocon, R., et al. (2014). Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care. Health Services Research, 49(5), 1498–1518.CrossRefPubMedPubMedCentral

Lindrooth, R. C., Lo Sasso, A. T., & Lurie, I. Z. (2006). The effect of distance to provider on employee response to changes in mental health benefits. Health Economics, 15(10), 1133–1141. https://doi.org/10.1002/hec.1118.CrossRefPubMed

Lo Sasso, A. T., & Byck, G. R. (2010). Funding growth drives community health center services. Health Affairs (Millwood), 29(2), 289–296.CrossRef

Merikangas, K. R., Bromet, E. J., & Druss, B. G. (2017). Future surveillance of mental disorders in the United States: Count people, not disorders. JAMA Psychiatry, 74(5), 431–432. https://doi.org/10.1001/jamapsychiatry.2017.0109.CrossRefPubMed

Murray, C. J., Barber, R. M., Foreman, K. J., Ozgoren, A. A., Abd-Allah, F., Abera, S. F.,… & Abu-Rmeileh, N. M. (2015). Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: Quantifying the epidemiological transition. The Lancet, 386(10009), 2145–2191.

National Center for Health Statistics (NCHS). (2017). 2013 Urban-rural classification scheme for counties. Retrieved from https://www.cdc.gov/nchs/data_access/urban_rural.htm.

National Institute of Mental Health (NIMH). (2017). Mental health information-statistics. Retrieved from https://www.nimh.nih.gov/health/statistics/mental-illness.shtml.

Neuhausen, K., Grumbach, K., Bazemore, A., & Phillips, R. L. (2012). Integrating community health centers into organized delivery systems can improve access to subspecialty care. Health Affairs (Millwood), 31(8), 1708–1716. https://doi.org/10.1377/hlthaff.2011.1261.CrossRef

Olfson, M., Kroenke, K., Wang, S., & Blanco, C. (2014). Trends in office-based mental health care provided by psychiatrists and primary care physicians. Journal of Clinical Psychiatry, 75(3), 247–253. https://doi.org/10.4088/JCP.13m08834.CrossRefPubMed

Regan, J., Schempf, A. H., Yoon, J., & Politzer, R. M. (2003). The role of federally funded health centers in serving the rural population. J Rural Health, 19(2), 117–124; discussion 115–116..CrossRefPubMed

Rosenbaum, S., Paradise, J., Markus, A. R., Sharac, J., Tran, C., Reynolds, D., & Shin, P. (2017). Community health centers: Recent growth and the role of the ACA. Kaiser Family Foundation. Retrieved from https://hsrc.himmelfarb.gwu.edu/sphhs_policy_ggrchn/60/.

Singh, P., Chakravarthy, B., Yoon, J., Snowden, L., & Bruckner, T. A. (2019). Psychiatric-related revisits to the emergency department following rapid expansion of community mental health services. Academic Emergency Medicine. https://doi.org/10.1111/acem.13812.

Small Area Health Insurance Estimates (SAHIE) Program. (2018). SAHIE datasets. US Census Bureau. Retrieved from https://www.census.gov/programs-surveys/sahie/data/datasets.html.

Small Area Income and Poverty Estimates (SAIPE) Program. (2018). SAIPE datasets. US Census Bureau. Retrieved from https://www.census.gov/programs-surveys/saipe/data/datasets.html.

Snowden, L. R. (2001). Barriers to effective mental health services for African Americans. Mental Health Services Research, 3(4), 181–187.CrossRefPubMed

Starfield, B., Powe, N. R., Weiner, J. R., Stuart, M., Steinwachs, D., Scholle, S. H., et al. (1994). Costs vs quality in different types of primary care settings. JAMA, 272(24), 1903–1908.CrossRefPubMed

StataCorp. (2015). Stata statistical software: Release 14. College Station, TX: StataCorp LP.

United States Census Bureau. (2016). Intercensal estimates of the resident population by five-year age groups, sex, race, and Hispanic origin for counties: April 1, 2000 to July 1, 2010. Retrieved from https://www.census.gov/data/datasets/time-series/demo/popest/intercensal-2000-2010-counties.html.

United States Census Bureau. (2018). Annual County resident population estimates by age, sex, race, and Hispanic origin: April 1, 2010 to July 1, 2017. Retrieved from https://www.census.gov/data/datasets/2017/demo/popest/counties-detail.html.

Vistnes, J. P., & Cohen, J. W. (2016). Gaining coverage in 2014: New estimates of marketplace and medicaid transitions. Health Affairs (Millwood), 35(10), 1825–1829.CrossRef

Wells, R., Morrissey, J. P., Lee, I. H., & Radford, A. (2010). Trends in behavioral health care service provision by community health centers, 1998–2007. Psychiatric Services, 61(8), 759–764. https://doi.org/10.1176/ps.2010.61.8.759.CrossRefPubMed

Title: Rapid Growth of Mental Health Services at Community Health Centers
Authors: Tim A. Bruckner
Parvati Singh
Lonnie R. Snowden
Jangho Yoon
Bharath Chakravarthy
Publication date: 01-09-2019
Publisher: Springer US
Keyword: Care
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 5/2019
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-019-00947-w

At a glance: The STEP trials

Springer Medicine

Rapid Growth of Mental Health Services at Community Health Centers

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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