Norquist G, Wells K
Division of Applied Research, National Institute of Mental Health, Rockville, MD 20857.
Arch Gen Psychiatry. 1991 May;48(5):475-8. doi: 10.1001/archpsyc.1991.01810290087016.
As many as 37 million Americans have no medical insurance, but no data exist on the mental health needs of community samples of the uninsured. Using interview data from a household sample in Los Angeles, we found that the uninsured had a higher prevalence of serious psychiatric disorder (16%) than those with private health insurance (12%), but had a prevalence similar to those with Medicaid (18%). Access to mental health services among those with a psychiatric disorder was similar in the uninsured (14.5%) and those with private insurance (18%) but was less than those with Medicaid coverage (42%). These results indicate that the uninsured have a great potential need for mental health services and that access might be improved through insurance plans such as Medicaid. However, further study is needed to determine the adequacy and quality of services provided under Medicaid and whether such a plan would improve access for an uninsured population such as the one studied here.
多达3700万美国人没有医疗保险，但对于未参保人群社区样本的心理健康需求却没有相关数据。利用洛杉矶家庭样本的访谈数据，我们发现，未参保者中严重精神疾病的患病率（16%）高于有私人医疗保险者（12%），但与有医疗补助者（18%）的患病率相似。患有精神疾病的未参保者（14.5%）和有私人保险者（18%）获得心理健康服务的比例相近，但低于有医疗补助覆盖者（42%）。这些结果表明，未参保者对心理健康服务有巨大的潜在需求，通过医疗补助等保险计划或许能改善他们获得服务的情况。然而，还需要进一步研究来确定医疗补助提供的服务是否充足和优质，以及这样一项计划是否能改善像本文所研究的未参保人群获得服务的情况。
