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Integrating Mental Health & Substance Abuse Strategies

Matching Strategies & Populations

Innovative Mental Health & Substance Abuse (MH/SA) Components in Other State Purchasing Programs


Gail Vail, M.P.A., Administrator, Acute Care Services, Medicaid Program Development, Florida Division of Medicaid, Florida Agency for Health Care Financing, Tallahassee, FL.

James Walkup, Ph.D., Assistant Professor, Rutgers University, New Brunswick, NJ.

This session highlighted examples of ways in which MH/SA-related needs may be addressed through other types of health care coverage and insurance programs.

Gail Vail of Florida's Agency for Health Care Financing, described how that State developed an innovative approach to address the mental health and substance abuse needs of certain children under its new Children's Health Insurance Program (CHIP).

In an effort to better address the significant needs of children age 5 to 18 with serious emotional disturbances or serious mental illness (i.e., schizophrenia, bipolar disorder, major depression, or substance abuse) and who meet certain treatment criteria, Florida established a new behavioral health network that provides an array of speciality behavioral health services to the children.

James Walkup of Rutgers University then described a research effort sponsored by a major disability insurance company that seeks to examine the extent to which the detection and treatment of previously undetected depression among persons with medical disabilities can reduce the length and severity of depressive episodes, reduce disability, and expedite return to work. Positive results from this study are likely to increase employers' and disability insurers' interest in pursuing effective interventions that will reduce productivity losses and insurance costs due to depression.

The implications of preventing persons with physical disabilities and co-occurring depression from leaving the workforce and onto State Medicaid programs as a result of their disabilities was also discussed.


Wells K, Strum R, Sherbourne C, et. al. Caring for Depression. Cambridge, MA: Harvard University Press; 1996. Chapter 3, The Social Role of Depression and Health Care Policy.

Schulberg H, Katon W, Simon G, et al. Treating Major Depression in Primary Care Practice: An Update of the Agency for Health Care Policy and Research Practice Guidelines. Arch Gen Psychiatry 1998 Dec;55:1121-7.

Marin JK, Blum TC, Beach S, et. al. Subclinical Depression and Performance at Work. Soc Psychiatry Psychiatr Epidemiol 1996;31:3-9.

Finklestein S, Berndt E, Greenberg SM, et. al. Improvement in Subjective Work Performance After Treatment of Chronic Depression: Some Preliminary Results. Psychopharmacol Bull 1996;32(1):33-40.

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