Lindsay Overhage
Dissertation Title: "Essays in Youth Mental Health: Exploring Emergency Care, Policy Interventions, and Pandemic Challenges"
In this dissertation, I explore the intricate dynamics shaping youth mental health services through three interrelated studies.
In the first essay, I examine the effects of inpatient psychiatric and residential care on children's and adolescents' mental health service utilization following emergency department boarding. Analyses utilized matching techniques and augmented inverse probability weighting. Analyzing retrospective Medicaid and Children’s Health Insurance Program insurance claims data from 2016 to 2019, I found that inpatient admissions significantly reduced return visits to the ED and subsequent psychiatric admissions in the short term. These findings highlight the importance of robust post-boarding care for improving youth mental health outcomes.
In the second essay, I utilize a stacked difference-in-difference approach to assess the impact of state bans on Sexual Orientation and Gender Identity Change Efforts (SOGICE), also known as conversion “therapies,” on youth mental health. Using data from the Youth Risk Behavior Survey (2011-2019), I found that bans led to significant and meaningful decreases in rates of seriously considering suicide among high school students. This evidence underscores the positive influence legislative bans can have on youth populations that are at increased risk for suicide.
In the third essay, my coauthors and I analyze trends in youth mental health care utilization during the COVID-19 pandemic, specifically emergency department visits, boarding durations, and inpatient admissions. Our analysis of national health insurance claims reveals increased ED visits, particularly among adolescent females, and a rise in prolonged boarding. This study highlights the urgent need to expand inpatient psychiatric resources to meet growing demands and reduce the strain on emergency services during crises.
Together, these essays contribute to our understanding of how crisis responses, policy changes, and global challenges influence mental health and mental health care for youth, offering insights into optimizing care strategies for young populations.