The substance abuse and Mental Health Services Administration (SAMHSA) has funded research that examines mental health and substance abuse (MH/SA) spending nationally from 1986 to 1996 and from 1987 to 1997.1 This research looks at aggregate spending by type of service and payer but does not explain the factors behind slower rates of spending for MH/SA services relative to those for all health care. Does this spending trend result from fewer people being treated, fewer services per person, or lower costs per unit of service? How do these underlying spending components contribute to spending on inpatient care, outpatient services, and prescription drugs?

The SAMHSA studies have not analyzed these types of questions because the data did not consistently provide the detail necessary to decompose spending into these underlying factors. A number of reports and papers funded by SAMHSA and others have analyzed various aspects of MH/SA services use and spending; space precludes a full description of these studies here. This paper adds to the emerging literature by focusing on trends in employer-based private insurance spending, which might differ in important ways from total mental health care spending. We examine the underlying factors influencing the trends in MH/SA spending in the private sector, by decomposing changes in covered private health insurance spending during 1992–1999 into changes in the probability of use, intensity of use, and cost per service used.

Full report: Trends_PrivHlthInsSpending.pdf (PDF | 92.68 kb)