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Children's mental health mostly covered by Medicaid despite gaps, study says

While most states cover many important types of treatment, the lack of maternal depression screening or ability to accurately track services delivered may hamper their efficacy.

By Stephen Feller
Children's mental health mostly covered by Medicaid despite gaps, study says
Although most states fund some portion of mental health services for low-income children through Medicaid, gaps in services include a lack of screening for maternal depression and somewhat ineffective ways of tracking services they deliver, report researchers at Columbia University in a recent study. Photo by Olimpik/Shutterstock

NEW YORK, Sept. 6 (UPI) -- A majority of states cover the most important of children's mental health services, but gaps found in some states lead researchers in a new study to suggest widening their availability.

While a large number of states cover three-quarters of key early-childhood mental health services, a lack of consistency or use of evidence-based measures, as well as most states not covering maternal depression screening as part of children's coverage, raised the ire of researchers at Columbia Medical School.

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For the study, published at the website of the National Center for Children in Poverty, researchers interviewed Medicaid administrators in 49 states and the District of Columbia about mental health services for children up to age 6 in their states.

The majority of states, researchers report, place few restrictions on the number of mental health services available to children, nor the type of treatment or number of treatments they are eligible for.

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The researchers found that between 34 and 46 states cover at least six of the eight key early childhood mental health services investigated: In-home treatment; services at a pediatric of family medical center; behavioral and health case management and care coordination; social-emotion screening; dyadic, or psychotherapeutic, treatment for families; and services at early care or educational setting.

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"Overall, an impressive number of states report Medicaid coverage of key mental health services in a range of settings, with few limitations on the number of screening or treatment visits," researchers wrote in the study, adding, however, that "there may be gaps between reported policy and service provision that can only be identified by further investigation."

Among the largest gaps, researchers say, are those for coverage of maternal depression screening, covered in just nine states, and parenting programs designed for parents of young children, which is only covered in 12 states.

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Even in the states that cover maternal depression issues, most cover screening in non-medical settings -- such as homeless shelters, family resource centers and WIC clinics -- but not in pediatric or family doctor's offices.

Dr. Sheila Smith, Early Childhood Director at the NCCP and lead author of the study, says this is a mistake because investing in a mother's mental health is akin to investing in children's health.

"Young children's behavioral health and development greatly depend on their mother's mental health, and early support for children's behavioral health is critical to later school success," Smith said in a press release.

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The researchers also note states appear to have limited ability to track trends of service delivery based on billing codes, including some that are used for other services, which may obscure the use and need for children's mental health services.

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"Policymakers and advocates can use the findings to examine actual services in their states and explore options for improving access and effectiveness through their Medicaid programs," Smith said.

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