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Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 22, Issue 4, 2019. Pages: 151-154
Published Online: 1 December 2019

Copyright © 2019 ICMPE.


 

PERSPECTIVES
Insurance Markets, Labor Markets, and the Mental Health Services Delivery System

Agnes Rupp,1* Michael C. Freed,1 Denise Juliano-Bult2

1Ph.D., Division of Services and Intervention Research, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
2MSW, Division of Services and Intervention Research, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA

* Correspondence to: Agnes Rupp, Senior Research Economist, NIMH/NIH 9000 Rockville Pike, Bethesda, MD 20892, USA.
E-mail: arupp@mail.nih.gov; rupp.agnes1976@gmail.com

Source of Funding: None declared.

Disclaimer: The views expressed in this paper are those of the authors, and no official endorsement by the National Institute of Mental Health, National Institutes of Health, or the U.S. Department of Health and Human Services is intended or should be inferred.

Abstract

Two important areas are highlighted in this review: (i) the impact of insurance and labor markets on the delivery of high-quality mental health services, and (ii) the need for advancements in method development and design in future studies. The complexity of health insurance markets created some unintended consequence of the mental health insurance parity legislation. Mental health provider shortages in local labor markets are a barrier to successful implementation and sustainment of innovative and evidence-based mental health service-delivery models for people with serious mental illness. Data-capture techniques that seamlessly integrate insurance claims with clinical outcomes (e.g., from electronic health records) will better equip health economists and other end-users with rigorous research findings to inform public health policy and practice recommendations. Despite early signals of success, larger sample sizes and more rigorous research designs are needed to refine predictive models of functional outcomes of evidence-based service-delivery models (e.g., coordinated specialty care model including supported education, and supported employment) for people with first-episode psychosis.


Introduction
: The authors are health scientist administrators at the National Institute of Mental Health (NIMH). The mission of NIMH is ``to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.'' As part of its portfolio, NIMH supports research on mental health economics, and mental health services research.

Method: In this perspective article, the authors comment on two papers presented at the NIMH-sponsored Mental Health Services Research Conference in 2018 and subsequently published in the September 2019 issue of the Journal of Mental Health Policy and Economics. Two important areas are highlighted in this review: (i) the impact of insurance and labor markets on the delivery of high-quality mental health services, and (ii) the need for advancements in method development and design in future studies.

Discussion: The complexity of health insurance markets created some unintended consequence of the mental health insurance parity legislation. Mental health provider shortages in local labor markets are a barrier to successful implementation and sustainment of innovative and evidence-based mental health service-delivery models for people with serious mental illness.

Implications for Research: Data-capture techniques that seamlessly integrate insurance claims with clinical outcomes (e.g., from electronic health records) will better equip health economists and other end-users with rigorous research findings to inform public health policy and practice recommendations. Despite early signals of success, larger sample sizes and more rigorous research designs are needed to refine predictive models of functional outcomes of evidence-based service-delivery models (e.g., coordinated specialty care model including supported education, and supported employment) for people with first-episode psychosis.

Received 22 October 2019; accepted 14 November 2019

Copyright 2019 ICMPE