Does private insurance adequately protect families of children with mental health disorders?
OBJECTIVE
Although private insurance typically covers many health care costs, the challenges faced by families who care for a sick child are substantial. These challenges may be more severe for children with special health care needs (CSHCN) with mental illnesses than for other CSHCN. Our objective was to determine if families of privately insured children who need mental health care face different burdens than other families in caring for their children.


METHODS
We used the 2005-2006 National Survey of Children With Special Health Care Needs (NS-CSHCN) to study privately insured children aged 6 to 17 years. We compared CSHCN with mental health care needs (N = 4918) to 3 groups: children with no special health care needs (n = 2346); CSHCN with no mental health care needs (n = 16250); and CSHCN with no mental health care need but a need for other specialty services (n = 7902). The latter group was a subset of CSHCN with no mental health care need. We used weighted logistic regression and study outcomes across 4 domains: financial burden; health plan experiences; labor-market and time effects; and parent experience with services.


RESULTS
We found that families of children with mental health care needs face significantly greater financial barriers, have more negative health plan experiences, and are more likely to reduce their labor-market participation to care for their child than other families.


CONCLUSIONS
Families of privately insured CSHCN who need mental health care face a higher burden than other families in caring for their children. Policies are needed to help these families obtain affordable, high-quality care for their children.
Busch
Susan H
SH
Division of Health Policy and Administration, Yale School of Public Health, Yale School of Medicine, New Haven, Connecticut 06520-8034, USA. susan.busch@yale.edu
Barry
Colleen L
CL
D000293:Adolescent; D002648:Child; D002669:Child Welfare / Q000191:economics*; D017281:Cost of Illness; D019988:Children with Disabilities / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics*; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000458:organization & administration*; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000191:economics*; D008605:Mental Health Services / Q000191:economics*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000191:economics; D012959:Socioeconomic Factors