title: Psychological Distress and Rates of Health Insurance Coverage and Use and Affordability of Mental Health Services, 2013-2014.
abstract: OBJECTIVE
  The study compared changes in rates of health insurance coverage, utilization and affordability of mental health services, and reported satisfaction with health coverage between 2013 and 2014 for people in moderate and severe psychological distress with people in no or low psychological distress.
  
  
  METHODS
  A nationally representative data set restricted to participants ages 26 to 65 (N=35,602) was used. Changes in outcome measures were calculated by using linear regression adjusted for the complex survey design.
  
  
  RESULTS
  Relative to individuals with no or low levels of psychological distress, individuals with moderate distress showed gains on selected outcome measures, and they experienced net improvements on several measures. Individuals with severe psychological distress showed fewer net improvements and no relative improvements compared with individuals with no or low levels of psychological distress, although they reported net increases in subjective satisfaction with health care.
  
  
  CONCLUSIONS
  Between 2013 and 2014, selected health care outcomes improved for individuals in moderate psychological distress but not for individuals in severe distress.
authors.affiliation: Mr. Phalen is with the School of Psychological Sciences, University of Indianapolis, Indianapolis (e-mail: peter.phalen@gmail.com ).
authors.forename: Peter Lee
authors.initials: PL
authors.lastname: Phalen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Health care reform, Mental health systems/hospitals, Mental illness &amp; alcohol/drug abuse, Epidemiology, Insurance