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Published Online: 2 August 2024

Effect of Providing Evidence-Based Mental Health Treatment on Retention in Care Among Medicaid-Enrolled Youths

Rebecca E. Stewart, Ph.D. [email protected], Nicholas C. Cardamone, B.S., M.S.Ed., Lisa Shen, M.C.I.T., Natalie Dallard, M.A., Carrie Comeau, M.S.W., David S. Mandell, Sc.D., Jill Bowen, Ph.D., and Aileen Rothbard, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
In Advance
https://doi.org/10.1176/appi.ps.20240066
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Abstract

Objective:

Youths who start behavioral health treatment often stop before completing a therapeutic course of care. To increase treatment engagement and quality of care, the Evidence-Based Practice and Innovation Center in Philadelphia has incentivized use of evidence-based practices (EBPs) for mental health care of youths. The authors aimed to compare treatment outcomes between youths who received EBP care and those who did not.

Methods:

Using EBP-specific billing codes and propensity score matching, the authors compared treatment retention among youths who received trauma-focused cognitive-behavioral therapy (TF-CBT; N=413) or parent-child interaction therapy (PCIT; N=90) relative to matched samples of youths in standard outpatient therapy (N=503).

Results:

Youths with a minimum of one session of TF-CBT or PCIT attended a second session at higher rates than did youths in the matched control group (TF-CBT: 96% vs. 68%, p<0.01; PCIT: 94% vs. 69%, respectively, p<0.01). On average, these returning youths attended more sessions in the EBP groups than in the control group (TF-CBT: 15.9 vs. 11.5 sessions, p<0.01; PCIT: 11.2 vs. 6.9 sessions, p<0.01).

Conclusions:

These findings indicate that, in addition to improving quality of care, EBP implementation helps address the major challenge that most youths who engage with treatment are not retained long enough for care to have therapeutic effects. Future research should examine the mechanisms through which EBPs can improve treatment retention.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
In Advance

History

Received: 8 February 2024
Revision received: 17 April 2024
Accepted: 15 May 2024
Published online: 2 August 2024

Keywords

  1. Child psychiatry
  2. Mental health systems
  3. Trauma-informed care
  4. Insurance
  5. Evidence-based practice

Authors

Details

Rebecca E. Stewart, Ph.D. [email protected]
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Nicholas C. Cardamone, B.S., M.S.Ed.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Lisa Shen, M.C.I.T.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Natalie Dallard, M.A.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Carrie Comeau, M.S.W.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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David S. Mandell, Sc.D.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Jill Bowen, Ph.D.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Aileen Rothbard, Ph.D.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Stewart, Cardamone, Shen, Mandell, Rothbard); Community Behavioral Health, Philadelphia (Dallard, Comeau); Department of Behavioral Health and Intellectual disAbility Services, Philadelphia (Bowen).
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Notes

Send correspondence to Dr. Stewart ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

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