Center for Children and Families, McCourt School of Public Policy, Georgetown University, Washington, D.C. (Burak); independent consultant, Washington, D.C. (Wachino).
Psychiatr Serv. 2023 Sep 1;74(9):970-977. doi: 10.1176/appi.ps.20220608. Epub 2023 Mar 29.
As state and federal policy makers seek to improve mental health, many aim to boost upstream approaches to prevent or mitigate diagnosable conditions. Home visiting offers a wholistic approach for new parents and children at home through health education, parenting support, and other services. Evidence of its benefits has accumulated across a growing number of home visiting models, some of which have demonstrated direct mental health outcomes, such as improved access to mental health services and reductions in family stress and maternal depression. Despite growing federal investments, home visiting reaches only a small fraction of families who might benefit. Public and private grant funding has successfully built and expanded home visiting in every state, but the current landscape of programs remains limited. As the nation's largest single coverage source for children, Medicaid, along with the Children's Health Insurance Program, has unsurpassed reach, to more than 40 million children and millions more families annually. Medicaid offers a natural vehicle to scale home visiting programs to promote early childhood development and address the mental health of both mothers and young children. To scale home visiting and reach far more families across the country who could benefit, federal policy makers should establish home visiting as a required Medicaid benefit and make additional investments to help states build capacity as the approach is scaled.
随着州和联邦政策制定者寻求改善心理健康，许多人旨在加强上游方法以预防或减轻可诊断的疾病。家访为在家的新父母和孩子提供了一种整体方法，通过健康教育、育儿支持和其他服务。越来越多的家访模式积累了其效益的证据，其中一些模式已经证明了直接的心理健康结果，例如改善获得心理健康服务的机会以及减少家庭压力和产妇抑郁。尽管联邦投资不断增加，但家访只覆盖了可能受益的一小部分家庭。公共和私人赠款资金成功地在每个州建立和扩大了家访项目，但目前的项目范围仍然有限。作为全国儿童最大的单一保险来源，医疗补助计划和儿童健康保险计划（CHIP）的覆盖面无与伦比，每年惠及超过 4000 万名儿童和数百万个家庭。医疗补助计划为扩大家访项目以促进儿童早期发展和解决母婴心理健康问题提供了一个自然的途径。为了扩大家访规模并惠及全国各地更多可能受益的家庭，联邦政策制定者应将家访作为医疗补助计划的一项强制性福利，并进行额外投资，以帮助各州扩大规模建设能力。
