Variations in Mental Health Need and Service Utilization by Insurance Type: Findings from a Population-Based Survey in California

As California implements the Patient Protection and Affordable Care Act (ACA) of 2010, it is important to examine the various types of insurance coverage and their association with mental health need and service utilization. Using data from the California Health Interview Survey (CHIS) 2011-2012, this current study compared the mental health need and service use of California adults with various insurance types. The findings revealed that respondents' various insurance types were differentially associated with their mental health need and service use. In citing reasons for not seeking treatment, the uninsured were more likely to be concerned about cost, and the Medicare & Others group was less likely to be concerned about cost than those with Privately Purchased insurance. The Employment-Based insurance group was significantly more likely than the Privately Purchased group to be "concerned about what would happen if someone found out". Further, both the uninsured and the Medicare & Others group were more likely to discontinue treatment compared to their Privately Purchased counterparts. The reasons for discontinuing treatment varied among the different insurance groups. The results suggest that the ACA will improve mental health by reducing concerns about cost reported by the uninsured. However, there is still a need for programs to address other barriers to treatment.