Service Utilization Before and After Self-Direction: A Quasi-experimental Difference-in-Differences Analysis of Utah's Mental Health Access to Recovery Program

Adm Policy Ment Health. 2020 Jan;47(1):36-46. doi: 10.1007/s10488-019-00969-4.

Abstract

Mental health self-direction involves participant control of an individualized budget to support recovery and wellness goals. This quasi-experimental study examined whether self-direction is associated with changes in service utilization. The study involved 2 years of administrative data for 94 self-directing participants and a matched comparison group of 529 non-participants with similar observed characteristics. Difference-in-differences were examined using four regression models predicting changes in four service utilization categories. Self-directing participants had greater increases in outpatient and rehabilitation services than the non-self-directing group, controlling for relevant covariates. There were no between-group differences in residential and emergency service utilization.

Keywords: Cost; Mental health self-direction; Recovery; Self-directed care; Service utilization.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Comprehensive Health Care / organization & administration*
  • Cost-Benefit Analysis
  • Female
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Mental Health Services / economics
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Regression Analysis
  • Self Care
  • Socioeconomic Factors
  • Utah