Use of mental health services by persons with a mental illness in nursing facilities: Initial impacts of OBRA87

Objective: To identify mental health service use patterns in nursing facilities subsequent to nursing home reforms in the Omnibus Budget Reconciliation Act of 1987. Methods: The study involves a retrospective analysis of Medicare Part B claims for mental health care for persons in a nursing facility in 1992 (N = 692) using the Medicare Current Beneficiary Survey. Mental health service use was described and analyzed using logistic regression. Results: Only 26% of nursing facility residents and 36% of residents with a mental illness had a mental health visit in 1992. Logistic regression confirms analyses prior to 1987 showing older residents and those in rural areas remain less likely to receive mental health visits. Discussion: Claims data collected after the passage of The Nursing Home Reform Act (NHRA) of 1987 indicate continued low levels of mental health treatment in nursing homes.