PURPOSE: To determine if Medicaid-enrolled youth with depressive symptoms receive adequate acute treatment, and to identify the characteristics of those receiving inadequate treatment. METHODS: We used administrative claims data from a Medicaid-enrolled population in a large urban community to identify youth aged 6-24 years who started a new episode of treatment for a depressive disorder between August 2006 and February 2010. We examined rates and predictors of minimally adequate psychotherapy (four visits in first 12 weeks) and pharmacotherapy (filled antidepressant prescription for 84 of the first 144 days) among youth with a new treatment episode during the study period (n = 930). RESULTS: Fifty-nine percent of depressed youth received minimally adequate psychotherapy, but 13 % received minimally adequate pharmacotherapy. Youth who began their treatment episode with an inpatient psychiatric stay for depression and racial minorities were significantly less likely to receive minimally adequate pharmacotherapy and significantly more likely to receive inadequate overall treatment. CONCLUSIONS: While the majority of youth appear to be receiving minimally adequate acute care for depression, a substantial number are not. Given current child mental health workforce constraints, efforts to substantially improve the provision of adequate care to depressed youth are likely to require both quality improvement and system redesign efforts.
PURPOSE: To determine if Medicaid-enrolled youth with depressive symptoms receive adequate acute treatment, and to identify the characteristics of those receiving inadequate treatment. METHODS: We used administrative claims data from a Medicaid-enrolled population in a large urban community to identify youth aged 6-24 years who started a new episode of treatment for a depressive disorder between August 2006 and February 2010. We examined rates and predictors of minimally adequate psychotherapy (four visits in first 12 weeks) and pharmacotherapy (filled antidepressant prescription for 84 of the first 144 days) among youth with a new treatment episode during the study period (n = 930). RESULTS: Fifty-nine percent of depressed youth received minimally adequate psychotherapy, but 13 % received minimally adequate pharmacotherapy. Youth who began their treatment episode with an inpatient psychiatric stay for depression and racial minorities were significantly less likely to receive minimally adequate pharmacotherapy and significantly more likely to receive inadequate overall treatment. CONCLUSIONS: While the majority of youth appear to be receiving minimally adequate acute care for depression, a substantial number are not. Given current child mental health workforce constraints, efforts to substantially improve the provision of adequate care to depressed youth are likely to require both quality improvement and system redesign efforts.
Authors: Joan Rosenbaum Asarnow; Lisa H Jaycox; Naihua Duan; Anne P LaBorde; Margaret M Rea; Lingqi Tang; Martin Anderson; Pamela Murray; Christopher Landon; Beth Tang; Diana P Huizar; Kenneth B Wells Journal: J Adolesc Health Date: 2005-12 Impact factor: 5.012
Authors: Carrie Farmer Teh; Mark J Sorbero; Mark J Mihalyo; Jane N Kogan; James Schuster; Charles F Reynolds; Bradley D Stein Journal: Health Serv Res Date: 2009-10-29 Impact factor: 3.402
Authors: Joseph H Puyat; Jamie R Daw; Colleen M Cunningham; Michael R Law; Sabrina T Wong; Devon L Greyson; Steven G Morgan Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2013-08-14 Impact factor: 4.328
Authors: Joyce H L Lui; Lauren Brookman-Frazee; Alejandro L Vázquez; Julia R Cox; Debbie Innes-Gomberg; Kara Taguchi; Keri Pesanti; Anna S Lau Journal: Adm Policy Ment Health Date: 2021-11-27