The Effect of Expanded Mental Health Benefits on Treatment Initiation and Specialist Utilization


  • Richard C. Lindrooth,

  • Anthony T. Lo Sasso,

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    • Address correspondence to Anthony T. Lo Sasso, Ph.D., Associate Professor, Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor, Chicago, IL 60612. Richard C. Lindrooth, Ph.D., Associate Professor, is with the Department of Health Administration and Policy, Medical University of South Carolina, Charleston, SC. Ithai Z. Lurie, M.A., Research Associate, is with the Institute for Policy Research, Northwestern University, Evanston, IL.

  • Ithai Z. Lurie


Objective. To measure the effects of a mental health benefit design change on treatment initiation for psychiatric disorders of employees of a large U.S.-based company.

Data Sources. Mental health treatment administrative claims data plus eligibility information provided by the company for the years 1995–1998.

Study Design. We measure the effect of a change in mental health benefits consisting of three major elements: a company-wide effort to destigmatize mental illness; reduced copayments for mental health treatment; and an effort to increase access to specialty mental health providers.

Data Extraction Methods. We identified the subsample of employees that were continuously enrolled in the company's health plan over the period 1995–1998, were between the ages of 18 and 65, and were actively employed.

Principal Findings. Our results suggest that the combined effect of destigmatization and reduced copayments led to an 18 percent increase (p<.01) in the probability of initiating mental health treatment. The results suggest that the effort to increase access to specialty providers was effective, but only for nonphysician providers: initiation at nonphysician mental health providers increased nearly 90 percent (p<.01) relative to nonspecialty providers, while use of psychiatrists declined by nearly 40 percent (p<.01).

Conclusions. Our results suggest that the benefit change increased initiation for mental health treatment overall and encouraged the use of nonphysician specialty mental health providers.