For parents grappling with mental health or substance use disorders, the ability to access treatment often determines whether they can maintain custody of their children. However, a recent analysis of health and child welfare records reveals a concerning trend: a significant number of eligible Medicaid recipients are not receiving the necessary treatment.
Conducted by researchers from the nonprofit institute RTI International and the Department of Health and Human Services, the analysis sheds light on the treatment gap among parents on Medicaid who are dealing with substance use disorders and have been flagged by authorities due to suspicions of child abuse or neglect. Alarmingly, less than half of these parents have received treatment.
Both mental health and substance abuse crises have swept across the nation, with repercussions extending to children affected by parental struggles. Substance use disorders can impair parental capacity and often involve the intervention of child protective services, leading to family separation.
According to federal data from 2021, over seven million children were referred to authorities due to concerns of maltreatment, resulting in the removal of more than 200,000 children from their homes. However, research indicates that parental engagement in treatment significantly reduces the likelihood of family separation.
To gauge treatment rates among Medicaid-enrolled parents, Tami Mark, a health economist at RTI, and her team utilized a novel dataset linking child welfare records in Florida and Kentucky with Medicaid claims records from 2020. Among the parents referred to welfare services, over half had been diagnosed with psychiatric or substance use disorders, compared to a third in the comparison group.
Of those with referrals, approximately 38% with mental health disorders and 40% with substance use disorders had received counseling, while approximately 67% with mental health disorders and 38% with substance use disorders had received medication. These figures, worse than general Medicaid treatment rates, underscore specific barriers faced by parents seeking care.
Norma Coe, an associate professor at the University of Pennsylvania specializing in medical ethics and health policy, highlighted systemic challenges in supporting parents and caregivers, noting the enduring effects on health and wealth across generations.
Identified barriers to treatment include stigma, logistical challenges, and fears of losing parental rights. The study authors advocate for enhanced coordination between social programs, emphasizing the integration of data systems to facilitate timely access to services.
However, Dr. Steven Woolf, a professor at Virginia Commonwealth University specializing in inequities, emphasized another critical hurdle: the shortage of treatment providers willing to accept Medicaid patients, given lower reimbursement rates compared to private insurers.
“Access to behavioral health services in the United States is inadequate,” Dr. Woolf remarked, “and even more so for Medicaid beneficiaries.”
