Paid Sick Leave Mandates and Mental Healthcare Service Use

带薪病假规定和心理保健服务的使用

• 批准号: 10635492
• 负责人: JOHANNA CATHERINE MACLEAN
• 金额: $ 64.12万
• 依托单位: GEORGE MASON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-15 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10635492
• 关键词: Address; Adopted; Adult; Affect; American; Appointment; Appointments and Schedules; Attention; Caring; Child; Chronic; Cities; Communities; Consumption; Country; County; Data; Data Sources; Developed Countries; Educational Status; Employee; Ethnic Origin; Family; Gender; Government; Health Care Costs; Health Personnel; Health Policy; Healthcare; Hour; Immune; Income; Individual; Infrastructure; Insurance Coverage; Laws; Literature; Major Depressive Disorder; Mediating; Medicaid; Medical; Mental Health; Mental Health Services; Mental disorders; Methods; Morbidity - disease rate; Motion; National Health Interview Survey; National Institute of Mental Health; Outcome; Patients; Pattern; Persons; Pharmaceutical Preparations; Policies; Population; Prevalence; Primary Care Physician; Privatization; Probability; Process; Provider; Psychiatrist; Public Health; Public Policy; Quality Indicator; Quasi-experiment; Race; Recommendation; Reporting; Reproducibility; Research; Residential Treatment; Schedule; Sick Leave; Societies; Socioeconomic Status; Suicide; Surveys; Time; Travel; Uninsured; United States; Variant; Visit; Wages; Wait Time; Work; barrier to care; clinical care; community-level factor; cost; design; effective therapy; experience; federal policy; flexibility; health care consultation; health care service utilization; health service use; improved; insurance claims; mortality; physical health service; prevent; service utilization; sex

PROJECT SUMMARY/ABSTRACT Mental health disorders are common, chronic, and costly health conditions for individuals, families, and communities. Treatment options are available, but treatment is underused with less than 50% of adults and 20% of children with mental health disorder receiving treatment each year. There are myriad reasons for not receiving treatment. A potential barrier that has received limited research attention is the time required to receive mental healthcare, which can be time consuming. Time constraints are likely salient for the employed, who much schedule mental healthcare appointments – either for themselves or their dependents – around work hours. The U.S. is one of three industrialized countries that does not have a federal policy that allow employees to take paid time off to attend to healthcare needs of themselves and their families. As of July 2021, 14 states and 21 cities have adopted paid sick leave (PSL) mandates that confer on average 7 days of PSL per year, mandated PSL can be used for mental healthcare. There is strong public support among Americans for PSL, 84% support PSL, and states and localities continue to adopt PSL mandates. The long-term objective of our proposed research is to assist in optimal design in public health policies that allow employees and their families to receive valuable mental healthcare and improve mental health. Specifically, the immediate objective of our application is to use rigorous quasi-experimental methods (e.g., difference-in-differences methods) and high quality, reproducible data (both insurance claims and survey data) to estimate the causal effect of PSL mandates on i) access to PSL among employees with mental health disorders, ii) use of mental healthcare among employees and their dependents (e.g., children and partners), and (iii) indicators for potential quality of mental healthcare received. We will study the extent to which community-level factors (mental healthcare workforce infrastructure, race/ethnicity, and socioeconomic status) mediate the causal effect of PSL mandates on our outcomes. Our data sources are IBM Marketscan commercial claims and the National Health Interview Survey. We will perform analyses separate for adults and children, using variation from all state and city PSL mandates through 2022. A rationale for our proposed research is that mental health disorders are leading causes of morbidity and mortality in the U.S. and use of mental healthcare are below recommended levels and PSL mandates are currently being adopted across the country, raising the importance of understanding how PSL can be used to remove barriers to treatment. Our project is significant by providing new information on the benefits of mandating PSL and potentially removing an under-studied, but empirically important, barrier to treatment: time.

项目摘要/摘要 对于个人，家庭和 社区。可以使用治疗方案，但是不到50％的成年人的治疗方法不足 每年有20％的精神健康障碍儿童接受治疗。没有多个原因 接受治疗。受到有限研究关注的潜在障碍是需要的时间 接受心理保健，这可能很耗时。时间限制对于员工来说可能是显着的， 谁安排心理保健任命（无论是自己还是他们的家属） 工作时间。美国是没有联邦政策的三个工业化国家之一 员工花时间休假来满足自己和家人的医疗保健需求。截至2021年7月， 14个州和21个城市已通过带薪病假（PSL）授权该会议平均为7天PSL 每年，授权的PSL可用于心理保健。美国人之间有强烈的公众支持 对于PSL，有84％的人支持PSL，各州和地区继续采用PSL授权。 我们拟议的研究的长期目标是协助制定公共卫生政策的最佳设计 允许员工及其家人获得宝贵的心理保健并改善心理健康。 具体而言，我们应用的直接目标是使用严格的准实验方法（例如， 差异差异方法）和高质量，可重复的数据（保险索赔和调查数据） 估计PSL授权对i）心理健康员工访问PSL的因果效应 疾病，ii）员工及其家属之间使用心理保健（例如儿童和伴侣）， （iii）收到的心理保健潜在质量的指标。我们将研究在多大程度上 社区级因素（心理保健劳动力基础设施，种族/种族和社会经济地位） 调解PSL授权对我们结果的因果影响。我们的数据来源是IBM MarketScan 商业索赔和国家健康访谈调查。我们将对成年人分开进行分析 儿童使用所有州和城市PSL的变化，直到2022年。 我们提出的研究的理由是，心理健康障碍是发病率的主要原因和 美国的死亡率和心理保健的使用低于建议级别，PSL授权为 目前在全国范围内被采用，提高了了解如何使用PSL的重要性 去除治疗的障碍。通过提供有关有关的新信息，我们的项目很重要 强制PSL并有可能消除研究不足但迫切重要的治疗障碍：时间。