The Role of State Medicaid Expansions in Integrating Comprehensive Mental Health Services into Opioid Treatment Programs
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ORIGINAL PAPER
The Role of State Medicaid Expansions in Integrating Comprehensive Mental Health Services into Opioid Treatment Programs: Differences Across the Rural/Urban Continuum George Pro1 · Zach Giano2 · Ricky Camplain3,4 · Shane Haberstroh5 · Carly Camplain6 · Denna Wheeler2 · Randolph D. Hubach2 · Julie A. Baldwin3,4,6 Received: 5 May 2020 / Accepted: 1 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Co-occurring mental health (MH) problems are common among those with opioid use disorders (OUDs). However, most opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states ( 𝛽=−0.038, SE = 0.005, p
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