Costs Keep Medical Students Away From Mental Health Care

Poor coverage creates obstacles for patient care at med school

(RxWiki News) It would seem logical that a medical school would provide adequate health coverage for its students, but it seems that largely, this is not the case.

High co-payment and coinsurance requirements, along with dollar and office visit limitations, are creating obstacles for medical students to receive needed mental health and substance abuse care.

"Medical students need better access to mental health care."

In the first study of its kind, researchers at the Harvard-affiliated Cambridge Health Alliance found that fewer than 22 percent of medical schools provide their students with complete coverage for mental health and substance abuse treatment. Rachel Nardin, MD, chief of neurology at Cambridge Health Alliance and lead author of the study, led a team that looked at 115 medical schools in the U.S. and found that nearly four out of five student health insurance plans require co-payments and coinsurance, which is the percentage of total cost that must be paid by the patient.

Some of the school insurance plans require co-pays of $20-25 per visit, and up to $500 for an inpatient stay. The median coinsurance rate was 20 percent. A majority of the plans had limits on the number of annual visits and/or total costs covered.

The study concluded that this means a single course of treatment for mental health issues or substance abuse could cost a medical student thousands of dollars out of their own pocket - money that most students, who are often racking up high student loan debt as well, can ill afford.

"Research shows out-of-pocket costs discourage patients from getting mental health and substance abuse treatment," Nardin said, adding that everyone deserves full access to needed medical care, including med students.

J. Wesley Boyd, MD, assistant clinical professor of psychiatry at Harvard Medical School and a senior author to the study, pointed out that medical students may be at higher risk of psychological distress than their peers, including depression and suicidality. These students need mental health services, and the community at large could suffer from the lack of it; psychological distress correlates with increases in medical errors for doctors in training, as well as lower levels of empathy and altruism.

The findings were published in a research letter to the Journal of the American Medical Association, in September 2011.

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Review Date: 
September 14, 2011