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Abstract

This brief presents data on mental health coverage benefits and enrollee's access to and use of mental health services through the Healthy Kids program in San Mateo County, California. The prevalence of mental health conditions among enrollees is similar to national levels, but despite the generous mental health benefits offered under the program, only a small fraction of enrollees with mental health conditions receive care. Reasons why more children do not use mental health services are explored. The brief also shows that enrollees with mental health needs have higher use of other health services compared to all Healthy Kids members. 

Introduction

Mental health care services have been shown to prevent juvenile delinquency and improve cognitive, academic, and social outcomes for children (Ramey and Ramey 1998; Zigler, Taussig, and Black 1992). However, for various reasons, not all children with mental health needs access necessary services. While mental health disorders affect one in five children living in the United States, only a fifth of all children who need mental health services receive them (Jellinek et al. 1999; U.S. Department of Health and Human Services [HHS] 1999). This unmet need for mental health services is especially high for Latino children relative to other children.

This brief provides data from San Mateo County, California, which provides subsidized health and mental health insurance to uninsured children in families with incomes below 400 percent of the federal poverty level who are ineligible for Medi-Cal (the federal-state insurance program for low-income children) and Healthy Families (California’s SCHIP program) because of family income or documentation status. This coverage is provided through the Healthy Kids program, which falls under the Children’s Health Initiative (CHI), an effort to extend health insurance to virtually all children in the county either through Healthy Kids, Medi-Cal, or Healthy Families.

In San Mateo County, Healthy Kids serves predominantly low-income, undocumented, Latino children whose first language is Spanish. The Healthy Kids program offers a comprehensive mental health benefits package. This brief discusses how many children are accessing mental health services through the program, how they access services, and possible reasons children who need services do not access them.

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The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

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