Most US Adults Support Mandatory Mental Health Coverage

Pam Harrison

October 07, 2015

More than three quarters of adults in the United States support mandated mental health coverage in health plans, a cross-sectional national poll indicates. However, support is stronger when substance abuse treatment is not explicitly included in that coverage.

Donovan Maust, MD, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, and colleagues found that 78% of 2124 respondents supported coverage for mental health care.

This proportion was higher than for birth control medications, at 66% (P < .001), and was equivalent to support for oral or dental care, at 76%.

On the other hand, the level of support for mental health care was lower than for screening tests for diabetes, for which there was 85% national support; vaccinations, at 86%; or mammograms and colonoscopies, at 86% and 89%, respectively (P < .001 for all comparisons).

In a multivariable model, support for coverage of mental health care was significantly higher among women, older respondents, non-Hispanic black respondents, and respondents with private insurance.

Having received prior medical care for depressed mood was most strongly associated with support for mandatory mental health care coverage.

"National dialogue regarding coverage for mental health treatment has accompanied implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA)," Dr Maust and colleagues observe in the October issue of Psychiatric Services.

"And these results suggest that the overall level of public support for mental health benefits, as well as the difference compared with support for other medical services, is essentially unchanged since Hanson's analysis of nearly 20 years ago."

The sample was from wave 20 of the C.S. Mott Children's Hospital National Poll on Children's Health, fielded in November 2013.

Roughly equal proportions of respondents were between the ages of 18 and 29 years (21%); 30 and 44 years (26%), 45 and 59 years (27%); and 60 years and older (26%).

Approximately half of the sample were women, and two thirds were non-Hispanic whites.

"Prior history of treatment for depressed mood had a pronounced effect among nearly every demographic group except for respondents who identified as Hispanic and non-Hispanic other, along with those at the highest income level, where support was not moderated by prior care," investigators point out.

Prior work has suggested that non-white patients and older patients are less likely to receive any mental health treatment.

"It may seem counterintuitive that support for a service would be strongest among those groups less likely to be recipients," Dr Maust and colleagues observe.

"But perhaps these groups have encountered obstacles accessing mental health care and are therefore strongly in support of guaranteed coverage."

They also point out that older adults have more years of accumulated experience and as such are more likely to have dealt with mental health problems and are hence more supportive of mandatory coverage for mental health care.

Respondents who were least likely to support mental health care coverage were men, those in the youngest age group, and respondents who were white.

The authors have disclosed no relevant financial relationships.

Psychiatr Serv. 2015;66:1101-1104. Abstract

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