Dissertation
Understanding multilevel factors that contribute to utilization of mental health services in children
Doctor of Philosophy (Ph.D.), Drexel University
Sep 2021
DOI:
https://doi.org/10.17918/00010801
Abstract
Approximately 20% of children in the US have a mental health condition and the proportion of those children who receive mental health care varies significantly between states, potentially because we do not understand how state policies influence the utilization of children's mental health services (CMHS). This mixed-methods study addressed this gap by determining policymakers' and advocates' perceptions of state policies that influence the utilization of CMHS and investigating the quantitative association between state policies and the utilization of CMHS. First, we used a modified Delphi method from February to April 2021 to identify the state policies and policy domains that state policymakers and advocates perceive as most important for positively impacting the use of CMHS and asked them to rate their financial feasibility and political acceptability. We found that the "school" policy domain was perceived as the most important, while the "social" policy domain had varying levels of perceived importance. School-based mental health services, state mental health parity, and Medicaid reimbursement rates were the individual policies perceived as most important. Ten out of 24 policies had high ratings for financial feasibility and political acceptability, however, no social policies were included. Second, we conducted multivariable logistic regression analysis using a novel dataset of state policies and data from the 2018-2019 National Survey of Children's Health to describe the relationship between state policies and receipt of mental health treatment in children with mental health conditions between the ages of 6-17 years old. Children living in states with higher Medicaid financial eligibility limits or state earned income tax credits had higher odds of receiving mental health services, while children living in states where Medicaid reimbursed for school mental health services had significantly lower odds of receiving mental health services. We provide the next steps for policymakers and advocates at the state level, as well as opportunities for future research.
Metrics
1076 File views/ downloads
22 Record Views
Details
- Title
- Understanding multilevel factors that contribute to utilization of mental health services in children
- Creators
- Katherine Lynn Nelson
- Contributors
- Jonathan Paul Purtle (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xii, 112 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health; Health Management and Policy; Drexel University
- Other Identifier
- 991022019718404721