Examining Patterns of Psychotherapy Service Utilization Among Medicaid-Enrolled Adolescents
OBJECTIVE: Adolescents with behavioral health disorders (i.e., mental health disorders and substance use) often experience frequent recurrence of symptoms, suggesting a need for an ongoing behavioral health intervention, rather than a single course of treatment. However, little is known about mental health care service use among adolescents over longer periods. The authors examined longitudinal patterns of outpatient behavioral health service utilization in a large sample of adolescents.
METHODS: Medicaid claims for 8,197 adolescents (ages 10.0-13.9 years, mean±SD=11.5±1.2; 61% male) from one Indiana county between 2006 and 2017 were examined, with a focus on outpatient psychotherapy visits. Latent class analysis (LCA) was used to detect clusters of longitudinal patterns of outpatient psychotherapy visits across 5 years, beginning with an adolescent's first behavioral health visit.
RESULTS: A five-class LCA model emerged with unique classes of service use based on duration and level of engagement (frequency) of monthly outpatient psychotherapy visits. Most adolescents fell in the nonuse class (38.7% of the sample). Additional classes were defined as late-onset low engagement (17.1%), early-onset high engagement (15.5%), early-onset moderate engagement (16.7%), and continuously high engagement (11.9%). Statistically significant differences were found across the classes in average duration and frequency of involvement (p<0.001), as well as in demographic characteristics (race, age, gender, and ethnicity) and behavioral health diagnoses (p<0.001).
CONCLUSIONS: These findings confirm that adolescents with behavioral health diagnoses do not follow a uniform pattern of psychotherapy utilization. The distinct patterns of service use point toward the need to identify appropriate long-term service recommendations for adolescents.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:74 |
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| Enthalten in: |
Psychiatric services (Washington, D.C.) - 74(2023), 4 vom: 01. Apr., Seite 374-380 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dir, Allyson L [VerfasserIn] |
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| Links: |
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| Themen: |
Adolescence |
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| Anmerkungen: |
Date Completed 04.04.2023 Date Revised 09.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1176/appi.ps.202100513 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 500 | |a Date Revised 09.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: Adolescents with behavioral health disorders (i.e., mental health disorders and substance use) often experience frequent recurrence of symptoms, suggesting a need for an ongoing behavioral health intervention, rather than a single course of treatment. However, little is known about mental health care service use among adolescents over longer periods. The authors examined longitudinal patterns of outpatient behavioral health service utilization in a large sample of adolescents | ||
| 520 | |a METHODS: Medicaid claims for 8,197 adolescents (ages 10.0-13.9 years, mean±SD=11.5±1.2; 61% male) from one Indiana county between 2006 and 2017 were examined, with a focus on outpatient psychotherapy visits. Latent class analysis (LCA) was used to detect clusters of longitudinal patterns of outpatient psychotherapy visits across 5 years, beginning with an adolescent's first behavioral health visit | ||
| 520 | |a RESULTS: A five-class LCA model emerged with unique classes of service use based on duration and level of engagement (frequency) of monthly outpatient psychotherapy visits. Most adolescents fell in the nonuse class (38.7% of the sample). Additional classes were defined as late-onset low engagement (17.1%), early-onset high engagement (15.5%), early-onset moderate engagement (16.7%), and continuously high engagement (11.9%). Statistically significant differences were found across the classes in average duration and frequency of involvement (p<0.001), as well as in demographic characteristics (race, age, gender, and ethnicity) and behavioral health diagnoses (p<0.001) | ||
| 520 | |a CONCLUSIONS: These findings confirm that adolescents with behavioral health diagnoses do not follow a uniform pattern of psychotherapy utilization. The distinct patterns of service use point toward the need to identify appropriate long-term service recommendations for adolescents | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a Adolescence | |
| 650 | 4 | |a Behavioral health disorder | |
| 650 | 4 | |a Outpatient treatment | |
| 650 | 4 | |a Utilization patterns and review | |
| 700 | 1 | |a Pederson, Casey A |e verfasserin |4 aut | |
| 700 | 1 | |a Ouyang, Fangqian |e verfasserin |4 aut | |
| 700 | 1 | |a Monahan, Patrick O |e verfasserin |4 aut | |
| 700 | 1 | |a Schwartz, Katherine |e verfasserin |4 aut | |
| 700 | 1 | |a Wiehe, Sarah E |e verfasserin |4 aut | |
| 700 | 1 | |a Aalsma, Matthew C |e verfasserin |4 aut | |
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