Variation in mental illness and provision of public mental health services
Authors: UVA Grads: William C. Johnson, Michael LaForest, Brett Lissenden & Prof. Steven Stern (Stony Brook).
Published recently in Health Services and Outcomes Research Methodology, this paper is an expansion of a previous study by Professor Steven Stern which estimated the local prevalence of mental illness in the Charlottesville area. That earlier paper caught the eye of state senator Creigh Deeds, who recognized how useful it would be to have the analysis extended to the entire state of Virginia. Three Economics graduate students then helped Professor Stern estimate the prevalence of mental illness within 30 geographical regions in the state of Virginia. After accounting for insurance status, they were able to compare estimates of demand for public mental health services to supply of public mental health services in each of those 30 geographical regions. Over 66,000 uninsured and Medicaid-insured individuals in Virginia were found to be without public mental health services. The deficit varies locally, with several regions having no deficit and others having 5,000 or more untreated people. Though a large portion of the unserved people with mental illness are uninsured, many would be insured for mental health services through Medicaid if Virginia were to accept the Medicaid expansion associated with the Affordable Care Act. The paper's findings suggest that states can better serve populations relying on mental health care by allocating scarce public mental health dollars to localities reflecting their need. The co-authors' results have been presented to a Virginia Senate joint subcommittee on mental health. The chart below shows the deficit of mental health services across Virginia's Community Services Boards for three values of PSUs (primary sampling units).