Mental health needs of the uninsured.

As many as 37 million Americans have no medical insurance, but no data exist on the mental health needs of community samples of the uninsured. Using interview data from a household sample in Los Angeles, we found that the uninsured had a higher prevalence of serious psychiatric disorder (16%) than those with private health insurance (12%), but had a prevalence similar to those with Medicaid (18%). Access to mental health services among those with a psychiatric disorder was similar in the uninsured (14.5%) and those with private insurance (18%) but was less than those with Medicaid coverage (42%). These results indicate that the uninsured have a great potential need for mental health services and that access might be improved through insurance plans such as Medicaid. However, further study is needed to determine the adequacy and quality of services provided under Medicaid and whether such a plan would improve access for an uninsured population such as the one studied here.

[1]  E. Ginzberg.  Medical care for the poor: no magic bullets. , 1988, Journal of the American Medical Association (JAMA).

[2]  P. Ries,et al.  Health care coverage by age, sex, race, and family income: United States, 1986. , 1987, Advance data.

[3]  M. Burnam,et al.  Six-month prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles. , 1987, Archives of general psychiatry.

[4]  M. Burnam,et al.  Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic whites. , 1987, Archives of general psychiatry.

[5]  G. Wilensky.  Viable strategies for dealing with the uninsured. , 1987, Health affairs.

[6]  Baldwin Mf.  Who will pay indigents' bill? , 1987 .

[7]  C. Taube,et al.  The Effect of Medicaid on Access to Ambulatory Mental Health Care for the Poor and Near-Poor Under 65 , 1986, Medical care.

[8]  B. Burns,et al.  Estimating the probability and level of ambulatory mental health services use. , 1986, Health services research.

[9]  P. Leaf,et al.  Contact With Health Professionals for the Treatment of Psychiatric and Emotional Problems , 1985, Medical care.

[10]  E. Skinner,et al.  Measuring Need for Mental Health Services in a General Population , 1985, Medical care.

[11]  M. Folstein,et al.  Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis. Experience in eastern Baltimore. , 1985, Archives of general psychiatry.

[12]  L G Kessler,et al.  The design of the Epidemiologic Catchment Area surveys. The control and measurement of error. , 1984, Archives of general psychiatry.

[13]  E. Skinner,et al.  Utilization of health and mental health services. Three Epidemiologic Catchment Area sites. , 1984, Archives of general psychiatry.

[14]  N. Lurie,et al.  Termination from Medi-Cal--does it affect health? , 1984, The New England journal of medicine.

[15]  M. Burnam,et al.  The Spanish Diagnostic Interview Schedule. Reliability and comparison with clinical diagnoses. , 1983, Archives of general psychiatry.

[16]  K. Davis,et al.  Uninsured and underserved: inequities in health care in the United States. , 1983, The Milbank Memorial Fund quarterly. Health and society.

[17]  S. Vernon,et al.  Measuring nonspecific psychological distress and other dimensions of psychopathology. Further observations on the problem. , 1981, Archives of general psychiatry.

[18]  R R Frerichs,et al.  Prevalence of depression in Los Angeles County. , 1981, American journal of epidemiology.

[19]  L. Robins,et al.  National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. , 1981, Archives of general psychiatry.

[20]  P. Shrout,et al.  Nonspecific psychological distress and other dimensions of psychopathology. Measures for use in the general population. , 1980, Archives of general psychiatry.

[21]  L. Radloff.  The CES-D Scale , 1977 .

[22]  K. Wells,et al.  How do HMOs reduce outpatient mental health care costs? , 1991, The American journal of psychiatry.

[23]  D. Jack,et al.  Diagnostic categorization by the Diagnostic Interview Schedule (DIS): A comparison with other methods of assessment. , 1986 .

[24]  A. Monheit,et al.  The employed uninsured and the role of public policy. , 1985, Inquiry : a journal of medical care organization, provision and financing.