Effects of mental health benefits legislation: A community guide systematic review

Theresa Ann Sipe, Ramona K.C. Finnie, John A. Knopf, Shuli Qu, Jeffrey A. Reynolds, Anilkrishna B. Thota, Robert A. Hahn, Ron Z. Goetzel, Kevin D. Hennessy, Lela R. McKnight-Eily, Daniel P. Chapman, Clinton W. Anderson, Susan Azrin, Ana Abraido-Lanza, Alan J. Gelenberg, Mary E. Vernon-Smiley, Donald E. Nease

Research output: Contribution to journalReview article

Abstract

Context Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence was limited for other mental health outcomes.

Original languageEnglish (US)
Pages (from-to)755-766
Number of pages12
JournalAmerican Journal of Preventive Medicine
Volume48
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Insurance Benefits
Legislation
Mental Health
Mental Health Services
Parity
Social Welfare
Quality of Health Care
Health Insurance
Health Expenditures
Health Services
Quality of Life
Morbidity
Mortality

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Sipe, T. A., Finnie, R. K. C., Knopf, J. A., Qu, S., Reynolds, J. A., Thota, A. B., ... Nease, D. E. (2015). Effects of mental health benefits legislation: A community guide systematic review. American Journal of Preventive Medicine, 48(6), 755-766. https://doi.org/10.1016/j.amepre.2015.01.022

Effects of mental health benefits legislation : A community guide systematic review. / Sipe, Theresa Ann; Finnie, Ramona K.C.; Knopf, John A.; Qu, Shuli; Reynolds, Jeffrey A.; Thota, Anilkrishna B.; Hahn, Robert A.; Goetzel, Ron Z.; Hennessy, Kevin D.; McKnight-Eily, Lela R.; Chapman, Daniel P.; Anderson, Clinton W.; Azrin, Susan; Abraido-Lanza, Ana; Gelenberg, Alan J.; Vernon-Smiley, Mary E.; Nease, Donald E.

In: American Journal of Preventive Medicine, Vol. 48, No. 6, 01.06.2015, p. 755-766.

Research output: Contribution to journalReview article

Sipe, TA, Finnie, RKC, Knopf, JA, Qu, S, Reynolds, JA, Thota, AB, Hahn, RA, Goetzel, RZ, Hennessy, KD, McKnight-Eily, LR, Chapman, DP, Anderson, CW, Azrin, S, Abraido-Lanza, A, Gelenberg, AJ, Vernon-Smiley, ME & Nease, DE 2015, 'Effects of mental health benefits legislation: A community guide systematic review', American Journal of Preventive Medicine, vol. 48, no. 6, pp. 755-766. https://doi.org/10.1016/j.amepre.2015.01.022
Sipe, Theresa Ann ; Finnie, Ramona K.C. ; Knopf, John A. ; Qu, Shuli ; Reynolds, Jeffrey A. ; Thota, Anilkrishna B. ; Hahn, Robert A. ; Goetzel, Ron Z. ; Hennessy, Kevin D. ; McKnight-Eily, Lela R. ; Chapman, Daniel P. ; Anderson, Clinton W. ; Azrin, Susan ; Abraido-Lanza, Ana ; Gelenberg, Alan J. ; Vernon-Smiley, Mary E. ; Nease, Donald E. / Effects of mental health benefits legislation : A community guide systematic review. In: American Journal of Preventive Medicine. 2015 ; Vol. 48, No. 6. pp. 755-766.
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abstract = "Context Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence was limited for other mental health outcomes.",
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