Association of Medicaid Status with Patient Mental Health Diagnosis: Data from the WA State Perinatal Psychiatry Consultation Line
type: CreativeWork
description: Background: Despite Medicaid’s critical role in covering perinatal and behavioral health care costs, many enrollees face barriers to timely mental health diagnosis and treatment. Understanding how insurance shapes access to mental health services and how this intersects with race and ethnicity is critical in addressing inequities in perinatal mental health care. The relationship between Medicaid insurance status and mental health diagnosis during the perinatal period as well as the role of race and ethnicity in this relationship is understudied. Methods: Study sample included 1,494 patients aged 18 to 40 (764 Medicaid enrollees and 730 non-Medicaid) identified from the Perinatal Psychiatry Consultation Line 2021-2024. Diagnosis of caller reported perinatal mental health diagnosis was categorized into three mutually exclusive groups: (1) depression and/or anxiety only, (2) bipolar disorder, substance use, PTSD, ADHD, or medical conditions only, and (3) any combination of bipolar substance use, PTSD, ADHD, or medical conditions diagnosis with depression and/or anxiety. Multinomial logistic regression models were used to calculate unadjusted and adjusted odds ratios relating insurance type (Medicaid insurance status as the exposure) to caller-reported perinatal mental health diagnosis. We repeated these analyses among Black or African American patients as well as non-Hispanic White patients to assess effect modification by race/ethnicity. Results: Among patients, 491 (32.9%) had depression and/or anxiety only diagnosis; 496 (33.2%) had bipolar disorder, substance use, PTSD, ADHD, or medical conditions only diagnosis; and, 507 (33.9%) had bipolar disorder, substance use, PTSD, ADHD, or medical conditions diagnosis with depression and/or anxiety. In adjusted multinomial logistic regression models, using the depression and/or anxiety only diagnosis category as the reference group, Medicaid-enrolled patients had significantly higher odds of having a caller-reported perinat…
abstract: Background: Despite Medicaid’s critical role in covering perinatal and behavioral health care costs, many enrollees face barriers to timely mental health diagnosis and treatment. Understanding how insurance shapes access to mental health services and how this intersects with race and ethnicity is critical in addressing inequities in perinatal mental health care. The relationship between Medicaid insurance status and mental health diagnosis during the perinatal period as well as the role of race and ethnicity in this relationship is understudied. Methods: Study sample included 1,494 patients aged 18 to 40 (764 Medicaid enrollees and 730 non-Medicaid) identified from the Perinatal Psychiatry Consultation Line 2021-2024. Diagnosis of caller reported perinatal mental health diagnosis was categorized into three mutually exclusive groups: (1) depression and/or anxiety only, (2) bipolar disorder, substance use, PTSD, ADHD, or medical conditions only, and (3) any combination of bipolar substance use, PTSD, ADHD, or medical conditions diagnosis with depression and/or anxiety. Multinomial logistic regression models were used to calculate unadjusted and adjusted odds ratios relating insurance type (Medicaid insurance status as the exposure) to caller-reported perinatal mental health diagnosis. We repeated these analyses among Black or African American patients as well as non-Hispanic White patients to assess effect modification by race/ethnicity. Results: Among patients, 491 (32.9%) had depression and/or anxiety only diagnosis; 496 (33.2%) had bipolar disorder, substance use, PTSD, ADHD, or medical conditions only diagnosis; and, 507 (33.9%) had bipolar disorder, substance use, PTSD, ADHD, or medical conditions diagnosis with depression and/or anxiety. In adjusted multinomial logistic regression models, using the depression and/or anxiety only diagnosis category as the reference group, Medicaid-enrolled patients had significantly higher odds of having a caller-reported perinat…
author: May, Dajonaea Aleesea
language: en_US
keywords: Insurance disparities, Medicaid, Perinatal mental health, Psychiatric Epidemiology, Racial and ethnic disparities, Epidemiology
date published: 2025-08-01
date modified: 2026-07-24T05:58:03Z
provider: University of Washington
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Washington

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property ID: Handle
value: https://hdl.handle.net/1773/53599