The Role of State Medicaid Expansions in Integrating Comprehensive Mental Health Services into Opioid Treatment Programs: Differences Across the Rural/Urban Continuum.
Health disparities
Health services
Mental health
Opioid use disorder
Journal
Community mental health journal
ISSN: 1573-2789
Titre abrégé: Community Ment Health J
Pays: United States
ID NLM: 0005735
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
05
05
2020
accepted:
01
10
2020
pubmed:
10
10
2020
medline:
10
8
2021
entrez:
9
10
2020
Statut:
ppublish
Résumé
Co-occurring mental health (MH) problems are common among those with opioid use disorders (OUDs). However, most opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states ([Formula: see text]=-0.038, SE = 0.005, p < 0.0001) than in expansion states ([Formula: see text]=-0.020, SE = 0.003, p < 0.0001). Access to integrated MH services was lowest in rural non-Medicaid expansion states, despite the high risk of opioid misuse and a high need for MAT and MH services in this population.
Identifiants
pubmed: 33033972
doi: 10.1007/s10597-020-00719-z
pii: 10.1007/s10597-020-00719-z
doi:
Substances chimiques
Analgesics, Opioid
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1017-1022Références
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