Abstract:
This study uses Texas\'s 2017 integration of the state disability and mental health agencies as a case study, combining interviews with Texas agency and advocacy organization leaders to examine perceptions of agency integration and augmented synthetic control analyses of 2014-2020 Medical Expenditure Panel Survey to examine impacts on mental health service use among individuals with co-occurring cognitive disabilities (including intellectual and developmental disabilities) and mental health conditions. Interviewees described the intensive process of agency integration and identified primarily positive (e.g., decreased administrative burden) impacts of integration. Quantitative analyses indicated no effects of integration on receipt of mental health-related services among people with co-occurring conditions. While leaders identified some potentially beneficial impacts of state agency integration, the limited impact of integration beyond the agency suggests that interventions at multiple levels of the service system, including those targeting providers, are needed to better meet the mental health service needs for this population.
摘要:
本研究以德克萨斯州2017年国家残疾和精神卫生机构整合为案例研究,结合与得克萨斯州机构和倡导组织领导人的访谈,以检查对机构整合的看法和2014-2020年医疗支出小组调查的增强综合控制分析,以检查对同时发生认知障碍(包括智力和发育障碍)和精神健康状况的个人的精神卫生服务使用的影响。受访者描述了机构整合的密集过程,并确定了主要是积极的(例如,减轻行政负担)一体化的影响。定量分析表明,融合对患有并存疾病的人接受心理健康相关服务没有影响。虽然领导人确定了国家机构整合的一些潜在有益影响,机构以外的整合的有限影响表明,在服务系统的多个层面上进行干预,包括那些目标提供商,需要更好地满足这一人群的精神卫生服务需求。