Mental Health

Southerners have higher financial burden for mental health/substance abuse treatment

About 11 percent of people using outpatient mental health and substance abuse (MH/SA) treatment in the South used more than 5 percent of their family's annual income to cover their out-of-pocket treatment costs from 2001 to 2005, according to a new study. Southerners paid the highest percentage of treatment costs out of their own pockets because they were most likely to use prescription medications for their treatment and they paid the greatest share (39 percent) of the costs of these medications, according to Agency for Healthcare Research and Quality researcher Samuel H. Zuvekas, Ph.D.

For other regions of the country, between 8 and 10 percent of MH/SA treatment recipients spent more than 5 percent of their family's annual income, and 10 percent did nationwide. Patient out-of-pocket costs included fees for psychiatrists, psychologists, social workers, and other specialty providers; MH treatment provided by primary care physicians; and medications. Dr. Zuvekas and Chad Meyerhoefer, Ph.D., of Lehigh University, also found that prescription medications accounted for almost two-thirds of out-of-pocket spending for outpatient MH treatment. The out-of-pocket costs of medications are generally beyond the scope of recently enacted Federal parity laws that will require equal coverage for MH services in most private health plans and Medicare, limiting the extent to which parity laws will reduce the financial burden of MH treatment.

See "State variations in the out-of-pocket spending burden for outpatient mental health treatment," by Drs. Zuvekas and Meyerhoefer, in the May/June 2009 Health Affairs 28(3), pp. 713-722.

Reprints (Publication No. 09-R056) are available from the AHRQ Publications Clearinghouse.

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