Policy Levers to Promote Access to and Utilization of Children’s Mental Health Services: A Systematic Review
Policies have potential to help families obtain behavioral healthcare for their children, but little is known about evidence for specific policy approaches. We reviewed evaluations of select policy levers to promote accessibility, affordability, acceptability, availability, or utilization of children’s mental and behavioral health services. Twenty articles met inclusion criteria. Location-based policy levers (school-based services and integrated care models) were associated with higher utilization and acceptability, with mixed evidence on accessibility. Studies of insurance-based levers (mental health parity and public insurance) provided some evidence for affordability outcomes. We found no eligible studies of workforce development or telehealth policy levers, or of availability outcomes.
KeywordsPsychological services Children’s mental health Policy Mental healthcare access Mental healthcare utilization
We thank Katherine Tucker for her expertise in the literature search. Preliminary findings of this research were presented at the Academy Health/National Institutes of Health 10th Annual Conference on the Science of Dissemination and Implementation in Health, Association of University Centers on Disability 2017 Annual Meeting, and 2018 Carter Center Georgia Mental Health Forum. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of CDC nor the U.S. government.
This research was supported by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention (CDC) administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC (for M. So and R.F. McCord’s contributions).
Compliance with Ethical Standards
Conflict of interest
M. So, R.F. McCord, and J.W. Kaminski declare no conflicts of interest.
This article does not contain any studies with human participants performed by any of the authors.
Informed consent was not required, since this was a review of existing literature and not of human subjects.
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