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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. Mental Health Benefits Legislation

Approach. Promote state policy mandating mental health coverage

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Overview. Mental health benefits legislation regulates health insurance to increase access to mental health services, including treatment for substance use disorders. Parity, a key part of most mental health benefits legislation, stipulates that health insurance plans do not impose greater restrictions for mental health coverage than for physical health coverage. (CG-Mental health).

Evidence. Scientifically Rigorous Evidence. Strategies with this rating are most likely to be effective. These strategies have been tested in multiple robust studies in a variety of populations and settings with consistently positive results, both on their own and in combination with other strategies. (Clarifying Note: The WWFH database calls this "scientifically supported evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.
  • Health Outcomes. This strategy helps contribute to reducing avoidable differences among socioeconomic and demographic groups or geographical areas in health status and health outcomes such as disease, disability, or mortality.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of state legislators educated on the importance of mental health parity legislation. (Measures efforts to build support for the policy)
  • Number of mental health support organizations engaged in promoting the legislation. (Assesses the breadth of community partner involvement)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of state residents who are aware of the mental health coverage mandate and their rights under the law. (Measures the effectiveness of public education efforts)
  • Percent of health insurance plans that comply with the parity requirements in the legislation. (Assesses the extent of policy implementation and enforcement)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of partnerships established between state agencies, insurers, and providers to support implementation of the mental health coverage mandate. (Engages key community partners in ensuring successful policy adoption)
  • Number of consumer assistance resources developed to help individuals understand and access their mental health benefits. (Supports effective utilization of the expanded coverage)

OUTCOME MEASURES:

  • Number of individuals who receive early intervention and treatment for mental health conditions as a result of the coverage mandate. (Demonstrates the potential for prevention and cost savings)
  • Number of individuals who are able to maintain employment and productivity due to receiving needed mental health treatment. (Reflects the broader social and economic benefits)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of the state population that is covered by insurance plans subject to the mental health coverage mandate. (Measures the policy's reach and potential for population-level impact)
  • Percent of mental health providers and supporters who report satisfaction with the implementation and enforcement of the mandate. (Evaluates community partner perceptions of the policy's effectiveness)

OUTCOME MEASURES:

  • Percent reduction in the treatment gap for mental health conditions in the state. (Shows the policy's impact on reducing unmet need and increasing access to care)
  • Percent of individuals with mental health needs who utilize covered services after implementation of the mandate. (Shows the impact on treatment access and utilization)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.