July 5, 2000
Contact: Emily Pearce, (615) 322-NEWS
[email protected]
Study of TennCare children shows the number with a serious emotional disorder is two to three times higher than state estimates
NASHVILLE, Tenn. - One-fourth of the children and adolescents in the TennCare program have a serious emotional disorder - a figure that is two to three times higher than state planning estimates, according to a recent Vanderbilt University study.
That translates into more than 80,000 children in Tennessee who meet the federal criteria for a serious emotional disorder and have chronic mental health problems, says Craig Anne Heflinger, senior research associate at the Vanderbilt Institute for Public Policy Studies (VIPPS) and principal investigator of the study. Children and adolescents, 4 to 17, are served under TennCare Partners, the state's managed care program for behavioral health services.
"This study gives us what we believe is the first comprehensive look at TennCare children, and we clearly are underidentifying and underserving a group of kids who need access to more resources not less," Heflinger said.
In fact, the study says more than half (55 percent) of the TennCare children with a serious emotional disorder had not received any mental health services during the past six months.
"TennCare is a good program, but we need to find better ways to implement and coordinate services so we can identify and treat these kids with serious emotional disorders," Heflinger said.
For example, "many parents did not know the name of their behavioral health organization, since it was not listed on the back of their TennCare card," Heflinger said. The physical health managed care organization was listed.
"They were accessing pediatricians, but the doctors were having trouble getting referrals for mental health visits. So there are systems problems and family issues - such as a lack of transportation and the stigma associated with mental illness - that are keeping parents from seeking help."
Heflinger said that while the level of serious emotional disorders in the TennCare population was slightly greater than those typically reported in other studies of community samples, it was within an expected range, given the characteristics of the population.
"Studies show that children from poorer families have more health and mental health problems than children from families with more economic resources," Heflinger said.
Part of a national study looking at the impact of managed care on vulnerable populations, the IMPACT report is the first in a series on issues related to mental health and substance abuse services for TennCare children. Under Heflinger's direction, the institute's Center for Mental Health Policy is carrying out the IMPACT study, an evaluation of Tennessee's managed care, Medicaid program and Mississippi's fee-for-service plan. The Mississippi report was completed in March.
The study's data is primarily based on two to three interviews with about 500 parents and TennCare children conducted over a two-year period starting in June 1997.
One unexpected finding was that children with a serious emotional disorder had significantly more physical health problems than other TennCare children. The most common chronic illnesses were asthma, allergies and speech or language disorders. "This shows we need better coordination between physical and behavioral health services," Heflinger said.
Other findings from the IMPACT study include the following:
-- The number one diagnosis reported was Attention Deficit Disorder (ADD), named by three-fourths (76 percent) of the TennCare parents who knew their child's mental health diagnosis.
-- Many TennCare children were on medication for mental health problems: 22 percent of all TennCare children and 50 percent of children with a serious emotional disorder.
-- The most frequently prescribed medication was Ritalin. Fifty-one percent of the children on medications took the stimulant used to treat ADD.
-- Parents or caregivers of children with a serious emotional disorder were significantly less satisfied with nearly all aspects of their TennCare behavioral and physical health plans than parents of other TennCare children.
-- When comparing Tennessee's managed care program with Mississippi and Pennsylvania's Medicaid plans, parents or caregivers of children with a serious emotional disorder gave significantly lower satisfaction ratings for their TennCare plan than did parents from the two other states.
-- The state's community mental health centers were the most frequent provider of mental health services. Almost two-thirds (62 percent) of children with a serious emotional disorder who had received a formal behavioral health service within the past six months had been seen at the community centers.
Additional reports based on follow-up interviews are being prepared by the VIPPS Center for Mental Health Policy and will look at 12-month outcomes, quality of care and trends in service use.
The IMPACT study, funded by the U. S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), is part of a national study that includes 13 states and examines four population groups: children with serious emotional disorders, adolescents with substance abuse problems, adults with serious mental illness and adults with chemical dependence. Information on the national study is available at http://www.hsri.org/coor.html.
The IMPACT study is a collaborative effort involving government agencies, providers and consumer advocacy groups, including the Tennessee Department of Mental Health and Mental Retardation, the Tennessee Commission on Children and Youth and the Tennessee Voices for Children.
If you would like to review the IMPACT study on TennCare children, it is available at http://www.vanderbilt.edu/VIPPS/CMHP/TennCareSED.pdf.
For more news about Vanderbilt, visit the Media Relations homepage at www.vanderbilt.edu/News.
-VU-
RSS