Browsing Health Policy & Management by Author "Benjenk, Ivy"
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- ItemThe medical home functions of primary care practices that care for adults with psychological distress: a cross-sectional study(Springer Nature, 2019-01-09) Linman, Shawn; Benjenk, Ivy; Chen, JiePrimary care practices are changing the way that they provide care by increasing their medical home functionality. Medical home functionality can improve access to care and increase patient-centeredness, which is essential for persons with mental health issues. This study aims to explore the degree to which medical home functions have been implemented by primary care practices that care for adults with psychological distress. Analysis of the 2015 Medical Expenditure Panel Survey Household Component and Medical Organizations Survey. This unique data set links data from a nationally representative sample of US households to the practices in which they receive primary care. This study focused on adults aged 18 and above. As compared to adults without psychological distress, adults with psychological distress had significantly higher rates of chronic illness and poverty. Adults with psychological distress were more likely to receive care from practices that include advanced practitioners and are non-profit or hospital-based. Multivariate models that were adjusted for patient-level and practice-level characteristics indicated that adults with psychological distress are as likely to receive primary care from practices with medical home functionality, including case management, electronic health records, flexible scheduling, and PCMH certification, as adults without psychological distress. Practices that care for adults with mental health issues have not been left behind in the transition towards medical home models of primary care. Policy makers should continue to prioritize adults with mental health issues to receive primary care through this model of delivery due to this population’s great potential to benefit from improved access and care coordination.
- ItemMental health and mental health services during the COVID-19 pandemic(2021) Benjenk, Ivy; Chen, Jie; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)The COVID-19 pandemic significantly impacted mental health and mental health services in the United States. During February 2021, 42% of Americans experienced symptoms of depression or anxiety. During the pandemic, the largest and most sustained growth in telemedicine occurred in mental health services. The goal of this dissertation is to explore strategies for maintaining mental health services and promoting mental health during the COVID-19 pandemic. In this work, I review the literature on what is currently known about the impact of the COVID-19 pandemic on mental health and mental health services. I provide conceptual frameworks that posit how vulnerable populations are at highest risk for losing access to healthcare during the pandemic and how population-level strategies are needed to promote mental health recovery. In my first research paper, I use qualitative data collected from semi-structured interviews with twenty adults with serious mental illness (SMI) during the pandemic. I found that most study participants did not experience increases in unmet mental health or social service needs. However, several participants who lacked identification documents, housing, and/or a personal device reported significant increases in unmet needs, including inability to access mental health care and public benefits. As many participants in the qualitative study reported receiving audio-only telemental health services versus video telemedicine during the pandemic, I used data from the Medicare Current Beneficiary Survey COVID-19 Supplements to explore the use of audio-only telemedicine during the pandemic. Findings suggest that the high rate of audio-only telemedicine is not exclusively related to the digital divide or patient preferences, but also to provider behavior. Lastly, as the COVID-19 pandemic impacted the mental health of the entire population, I used data from the Census Bureau’s Household Pulse Survey to explore whether availability and receipt of an effective COVID-19 vaccine could promote mental health. Results suggest a reduction in the predicted probability of mental health symptoms after approval of the vaccine and a lower predicted probability of mental health symptoms among those who have been vaccinated, however these rates remain higher than what was seen prior to the pandemic. Overall findings suggest that the mental health care system has adapted fairly well to meet the needs of persons with SMI during the pandemic and mental health has improved since the approval of the vaccine, but additional work will be needed to reengage those who were disconnected from mental health services during the pandemic and to achieve pre-pandemic levels of mental health.