{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T04:09:34Z","timestamp":1747282174321,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA044284"],"award-info":[{"award-number":["R01DA044284"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Oregon introduced a state policy, HB 3090, on October 6, 2017, which increased requirements on emergency departments (EDs) to improve transitions to outpatient mental health care. The objective of this study was to examine the policy's impact among low\u2010income adolescent patients who face severe barriers to follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study of visits by Medicaid enrollees ages 14\u201318 presenting to any Oregon ED for a mental health concern between January 1, 2016, and December 31, 2019. We calculated standardized mean differences and used interrupted time series models to evaluate the association of HB 3090 with 14\u2010day mental health follow\u2010up, in\u2010ED services, and inpatient admissions, adjusting for gender, race\/ethnicity, primary language, and calendar months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 26,071 adolescent mental health\u2013related ED visits, we found an estimated increase of 3.63 percentage points (pp; 95% confidence interval [CI] 0.27 to 6.99) in the adjusted probability of a 14\u2010day outpatient mental health claim postpolicy. However, this effect was attenuated over time, with a slope change of \u22120.25\u2009pp (95% CI \u22120.5 to 0) for each month thereafter. The probability of receiving mental health services in the ED or inpatient admission did not change in association with the policy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was a small increase in short\u2010term outpatient mental health visits after the policy, but the association weakened over time, and other key outcomes did not change. Putting pressure on EDs to perform better in this area is likely to be a minimally effective strategy without accompanying strengthening of mental health resources.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.15063","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T15:49:55Z","timestamp":1737042595000},"page":"526-531","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of an Oregon health policy aimed at strengthening adolescent linkage to outpatient mental health care from the emergency department"],"prefix":"10.1111","volume":"32","author":[{"given":"Liliya","family":"Kraynov","sequence":"first","affiliation":[{"name":"ValleyWise Health  Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Charlesworth","sequence":"additional","affiliation":[{"name":"Center for Health Systems Effectiveness, Department of Emergency Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-5745","authenticated-orcid":false,"given":"Esther","family":"Choo","sequence":"additional","affiliation":[{"name":"Center for Policy &amp; Research in Emergency Medicine, Department of Emergency Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. John","family":"McConnell","sequence":"additional","affiliation":[{"name":"Center for Health Systems Effectiveness, Department of Emergency Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2014.09.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12282"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922816684609"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-1536"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000343"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2022.0056"},{"key":"e_1_2_9_9_1","unstructured":"Workforce Maps by State.American Academy of Child & Adolescent Psychiatry (AACAP). Accessed March 12 2024.https:\/\/www.aacap.org\/aacap\/Advocacy\/Federal_and_State_Initiatives\/Workforce_Maps\/Home.aspx"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.00805"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2024.0210"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001920"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1174"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2013-0079"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.18377"},{"key":"e_1_2_9_16_1","unstructured":"2017 ORS 441.053. OregonLaws.org. Accessed October 19 2019.https:\/\/www.oregonlaws.org\/ors\/441.053"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1571"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2009.00633.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-057383"},{"key":"e_1_2_9_20_1","unstructured":"Emergency Department Discharge Practices for Behavioral Health Crisis Care: A Statewide Survey of Hospitals. Legislative Report. Oregon Health Authority.2022. Accessed December 21 2023.https:\/\/sharedsystems.dhsoha.state.or.us\/dhsforms\/served\/le4272.pdf"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2013.08.002"},{"key":"e_1_2_9_22_1","unstructured":"Discharge of Patients Receiving Mental Health Treatment. Chapter\u00a0441 Health Care Facilities. Oregon State Legislature.2015. Accessed December 1 2022.https:\/\/www.oregonlegislature.gov\/bills_laws\/ors\/ors441.html"},{"key":"e_1_2_9_23_1","unstructured":"House Bill 2023. The Oregonian.2015. Accessed December 12 2022.https:\/\/gov.oregonlive.com\/bill\/2015\/HB2023\/"},{"key":"e_1_2_9_24_1","unstructured":"HowellC.Crisis Mode: Oregon's Lack of Mental Health Resources Remains Large Concern. Pamplin Media Group. Accessed December 19 2023.https:\/\/www.lakeoswegoreview.com\/news\/crisis\u2010mode\u2010oregons\u2010lack\u2010of\u2010mental\u2010health\u2010resources\u2010remains\u2010large\u2010concern\/article_ba17b6fa\u20108ab8\u201056a2\u201085a0\u201084c17b035988.html"},{"key":"e_1_2_9_25_1","unstructured":"HB 2086 (2021) Report (Sections\u00a013\u201015): Intensive Behavioral Health Treatment Services for Children and Adolescents: Capacity And Demand. Oregon Health Authority.2022. Accessed December 15 2023.https:\/\/www.oregon.gov\/oha\/erd\/siteassets\/pages\/government\u2010relations\/hb%202086_intensive%20behavioral%20health%20treatment%20services%20report_oha_december%202022.pdf"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.15063","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T11:19:44Z","timestamp":1747221584000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.15063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/acem.15063"],"URL":"https:\/\/doi.org\/10.1111\/acem.15063","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"type":"print","value":"1069-6563"},{"type":"electronic","value":"1553-2712"}],"subject":[],"published":{"date-parts":[[2025,1,16]]},"assertion":[{"value":"2024-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}