Children and youth face major gaps in access to mental and behavioral health services. Rates of identification of mental health conditions in the pediatric population continue to lag well behind what we know about the prevalence of these conditions. In addition, most children and youth with identified disorders do not get adequate treatment.
Some access problems reflect major limitations in the mental health workforce (far too few child psychiatrists, psychologists, developmental-behavioral pediatricians, and other mental health professionals). Workforce limitations in turn reflect the weak financial base for children’s mental health services, providing relatively few incentives for young people to enter the children’s mental health workforce.
We all hoped that a mandated parity of mental and physical health services would lower out-of-pocket costs and improve payment, thereby improving workforce and access issues.
However, this Pediatrics study shows that parity has some (but only limited) impact on the access to and costs of mental health services. Programs that integrate mental health services with physical health services (both in community pediatric practices and in subspecialty programs) help change the paradigm of unmet mental health needs.
Can mental health parity help address the mental and behavioral health gap in children’s health and improve access to mental health services?
The current study offers some hope, although it also suggests the need to monitor and enforce parity better than what seems to have occurred at least in its early years. Parity seems less likely to improve preventive efforts unless mental health benefits clearly support the many effective preventive interventions.
With a growing emphasis on the importance of mental and behavioral health and their influences on many other aspects of the health of children and adults, it may be time to think more imaginatively about health care financing that can better ensure attention to mental health concerns broadly. New alternative payment models could help, especially if data are collected on process and outcome measures related to mental health, but the current study highlights the need to improve the financing of mental and behavioral health care.
From AAP News & Journals. Originally published in the journal Pediatrics.