(PS5-17) Characteristics of Families Seeking Specialty Anxiety Treatment in an Urban Setting by Insurance Status

Background: Families of youth struggling with anxiety face unique challenges in accessing and engaging with mental health services. In addition to the barriers all families face in accessing care, families of anxious youth are also hampered by limited availability of programs that offer exposure therapy, which is the gold-standard recommended treatment for anxiety. Identifying the characteristics of families seeking care within a community mental health setting and whether there are differences as a function of insurance status can highlight potential disparities in access to care. This can in turn shape interventions and outreach aimed at improving families’ access to treatment.

Methods: We analyzed administrative data from families who expressed interest in anxiety services for their child at a specialty anxiety program embedded in an urban community mental health center between 2019-2023 (n=330). Families completed an initial screen before scheduling an intake appointment, where they reported on insurance coverage, custody status, mental health treatment and medication history, and primary symptom concerns. We characterized demographics, primary clinical concerns, and past treatment history of those seeking care, and examined how these demographics varied by Medicaid (public insurance; n= 129, 39.7%) vs. non-Medicaid (e.g., commercial insurance or self-pay; n= 196, 60.3%) status.

Results: Treatment-seeking youth were mostly female (58.2%) with a M age of 10. 73.3% of families reported joint custody and 55.0% of youth had received prior mental health treatment. Primary concerns for which youth were seeking care included general anxiety (88.2%), depression (50.7%), and obsessive-compulsive disorder (OCD; 46.0%); less common concerns included separation anxiety (29.9%), selective mutism (26.4%), and tics (20.9%). Youth with Medicaid (M = 11.20) were slightly older than youth without (M = 10.55), although this was not significant (t₍₃₁₆₎ = -1.47; p = .71). Chi-squared analyses showed that primary concerns did not vary as a function of whether or not families had Medicaid (all ps > .05) nor were there differences in whether youth had received prior treatment between groups. Youth on Medicaid were more likely to be in single-parent homes than those not on Medicaid (X² ₍₁₎ = 21.9, p < .001).

Conclusion: Characteristics were generally consistent across families seeking services regardless of insurance coverage, with the exception that Medicaid youth were more likely to live in single-parent homes. Findings suggest anxiety concerns are comparable across families from diverse socioeconomic backgrounds. Small differences in age at the time services were sought may suggest that it takes Medicaid families longer to identify and access specialty mental health services; however, this finding should be interpreted with caution due to the small effect size. Implications for outreach efforts will be discussed.