Trends in Mental Health and Substance Abuse Services at the Nation's Community Health Centers: 1998-2003

• Published in: American journal of public health (1971) Vol. 96; no. 10; pp. 1779 - 1784
• Main Authors: Druss, Benjamin G, Bornemann, Thomas, Fry-Johnson, Yvonne W, McCombs, Harriet G, Politzer, Robert M, Rust, George
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.10.2006; American Public Health Association; American Journal of Public Health 2006
• Subjects: Addictions; Adolescent; Adult; Aged; Biological and medical sciences; Child; Community; Community Mental Health Centers - statistics & numerical data; Community Mental Health Centers - trends; Community Mental Health Services - statistics & numerical data; Community Mental Health Services - trends; Continental Population Groups; Crisis intervention; Demography; Directors; Drug abuse; Emergency medical care; Emergency services; Ethnic Groups; Female; General aspects; Generalized linear models; Health care; Health facilities; Health services; Humans; Indigent care; Male; Medicaid; Medical sciences; Medical treatment; Mental depression; Mental health; Mental health care; Mental Health Services - statistics & numerical data; Mental Health Services - trends; Middle Aged; Miscellaneous; Onsite; Patients; Poverty - statistics & numerical data; Primary care; Primary Health Care - statistics & numerical data; Primary Health Care - trends; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression analysis; Research and Practice; Substance abuse treatment; Substance-Related Disorders - rehabilitation; Trends; Uninsured people; United States; Workforce; Workforce planning; United States; North America; America; Human; Drug addiction; Health center; Mental health; Trend; Mental disorder; Community health; Health service; Substance abuse; Epidemiology; Public health; Public sector
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2005.076943

We examined trends in delivery of mental health and substance abuse services at the nation's community health centers. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care's (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210,000 to 800,000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve.