THE RELATIONSHIP BETWEEN INSURANCE-COVERAGE AND PSYCHIATRIC-DISORDER IN PREDICTING USE OF MENTAL-HEALTH-SERVICES

Objective: This study investigated how insurance coverage for mental h ealth services affects outpatient mental health service utilization am ong those with and among those without a DSM-III psychiatric diagnosis . The authors used a representative community sample to compare the re gression effects of insurance coverage on utilization of mental health services among these subjects. Method: Data are from the second wave of the Piedmont, North Carolina, site of the Epidemiologic Catchment A rea project. These data contain DSM-III diagnostic measures derived fr om the National Institute of Mental Health Diagnostic Interview Schedu le as well as measures of insurance coverage and utilization. Response s from 2,889 community residents were analyzed using both ordinary lea st squares and logistic regression. Results: In both models, insurance coverage was strongly associated with care among those with as well a s among those without a psychiatric disorder. The association between coverage and the probability of care was strongest among those with a disorder. Conclusions: The findings are not consistent with the claim that failing to provide insurance coverage will reduce discretionary h ut not necessary mental health cars utilization. They provide evidence that failing to provide insurance coverage will reduce utilization as much or more among those with a psychiatric disorder as among those w ithout. This result has important implications for health care reform.