Challenges for Insured Patients in Accessing Behavioral Health Care.

The Patient Protection and Affordable Care Act (ACA) mandates that health insurance plans include sufficient access to behavioral health providers, but lacks specific guidelines to define sufficient access Using a secret shopper methodology, we called behavioral health providers in the Denver metropolitan area networked with 3 large insurance companies. We found that, depending on insurance company and level of training, 9.8% to 59% of providers could offer a new patient appointment, with psychiatry appointments being particularly difficult to schedule. These findings are consistent with similar studies conducted in other regions, suggesting that access to outpatient behavioral health care is limited despite existing ACA regulations.

Findings from mental health screening of newly arrived refugees in Colorado.

States are required to provide a public health screening for all newly arrived refugees in the United States. In 1997, a comprehensive program was created to include both a physical examination and a mental health screening. This article provides a complete description of the mental health screening process, including two illustrative cases, and reports information about the refugees who participated in the program. Ten percent of screened refugees were offered mental health referrals; of those, 37% followed up. Refugees who presented for treatment reported a higher number of symptoms upon screening compared with those who were offered referrals but did not follow up. Psychiatric evaluation confirmed that those who screened positive and presented for treatment were experiencing a high level of suffering and qualified for mental health diagnoses. The findings support inclusion of a mental health screening as part of the public health screening.