This study will use the Medical Expenditure Panel Survey (MEPS) to examine the financial burden that rural residents face in seeking mental health services, compared to urban residents. This study will also assess the implications of financial burden for access to needed mental health services for rural residents. Developing an understanding of how mental health service use affects the financial well being of rural families (and the emotional well-being of rural individuals) will provide policymakers with evidence that informs mental health policy interventions. For example, if many privately insured rural residents face high out-of-pocket costs for mental health services, policymakers may want to strengthen the rural mental health safety net (i.e. by providing subsidies to rural mental health professionals). If the hypothesized rural-urban disparities are linked primarily to individual and small group coverage, this may indicate a need to reform existing mental health parity laws.

This study asks the following research questions:

1. What proportion of rural versus urban residents with private insurance have a policy that covers mental health services?
2. What are the out-of-pocket costs by rural residents who seek mental health treatment and how do these compare to urban residents (in raw dollars, as a proportion of mental health charges, as a proportion of family income)?
3. How do out-of-pocket costs compare for service users based on rurality, controlling for employer size or other characteristics?
4. Are rural residents more or less likely than urban residents to report financial barriers to accessing mental health services? Is there evidence of unmet need for mental health services among rural residents, based on their responses to screenings for mental status?

Products of this project will include a working paper, an article submitted to a peer-reviewed journal, and presentations at relevant conferences.

Publications

• Rural Adults Face Parity Problems and Other Barriers to Appropriate Mental Health Care
  Maine Rural Health Research Center
  Date: 11/2008
  The findings of this policy brief suggest that a multi-level approach is essential for meeting the mental health service needs of rural residents.