Economic Antecedents of Medicaid-Financed Mental Health Services Among Youths in California

Purpose: The literature reports that downturns in the economy may increase utilization of adult mental health services. However, whether economic decline affects the use of mental health services among youth remains unclear. We test whether demand for California's publicly financed mental health services for children varies with labor market contraction. Methods: We apply time-series methods to monthly counts of unduplicated clients served, from July 2002 to April 2008, for California Children's Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. We use as the independent variable monthly unemployment insurance claims in California that result from mass layoffs. Results: Increases in the number of unemployment insurance claims due to mass layoffs in California coincide with higher than expected monthly values of EPSDT services. Exploratory analyses find that expansions in public health insurance enrollment do not account for the discovered increase in EPSDT services. Conclusions: ...