Magazine article Developments in Mental Health Law

National Mental Health Services Survey: Virginia Summary

Magazine article Developments in Mental Health Law

National Mental Health Services Survey: Virginia Summary

Article excerpt

Introduction

Access to mental health services (MHS) remains a significant problem in the United States. (1) Even as more Americans gain insurance coverage, actual access to care can vary greatly depending on regional characteristics such as degree of development, population density, or other socioeconomic factors. (2) Variance in provider acceptance of different insurances or payment methods can also seriously limit access to MHS. (3) The recent increase in psychiatric civil commitment in Virginia (4) has raised concerns about access to different mental health services within the state. In this report, we use data from a national survey to give an overview of MHS in Virginia.

Data Source

The 2010 National Mental Health Services Survey (N-MHSS) was conducted by the United States Department of Health and Human Services in order to gather data on all mental health treatment facilities within the United States. The survey was conducted via mail questionnaire, telephone interview, and web-based survey. The data that N-MHSS collects uniquely encompasses state-level and national data for both public and private facilities. Such an expansive data set provides a useful overview of information such as the types of mental health treatment facilities, types of services offered, infrastructure, and client demographics. Presented below is a brief overview of some characteristics of mental health treatment facilities within Virginia. (5)

Inclusion and Exclusion Criteria

The N-MHSS does not collect data from facilities that provide treatment only to incarcerated persons, DoD facilities, and individual/small group facilities not licensed or certified as part of a mental health center or clinic. (6) For our sub-analysis of N-MHSS data, we limited our queries to Virginia facilities, and excluded facilities of the "multi-setting facilities" type due to extremely limited sample size.

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Over 50% of each facility type reported having a crisis team (onsite, offsite, or both). Outpatient facilities reported the smallest proportion of onsite-only crisis teams (8.95%) and the largest proportion of both onsite and offsite crisis teams (29.47%). The other three facility types reported the opposite trend, each having a fairly large proportion of onsite-only crisis teams (>36.67%) and a small proportion of both onsite and offsite crisis teams (<10%). None of the psychiatric hospitals in the survey reported having offsite-only crisis teams.

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Very few of any of the facility types were licensed by the US DHHS. Every psychiatric hospital in the survey reported licensing from the Joint Commission. A large portion of all facility types were licensed by state mental health/substance abuse agencies.

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All psychiatric hospitals and general hospitals offered inpatient services, whereas almost all residential and outpatient facilities did not offer inpatient services. General hospitals and psychiatric hospitals were both split approximately evenly on outpatient services.

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Notably, there was great variance in responses among different types of facilities. Over 50% of psychiatric hospitals, psychiatric units within general hospitals, and outpatient facilities admitted seniors. Only 20.6% of residential facilities admitted seniors. Only 16.7% of general hospitals admitted children/adolescents, whereas over 50% of each of the other facility types admitted children/adolescents.

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The majority of each type of Virginia MHS facility did not provide specialized support services, such as employment support, housing support, and legal support. The most common type of support service was walk-in mental health emergency services.

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Medicaid was a significant contributor of funding (>75%) for each type of MHS facility. …

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