Prevalence of mental health conditions among individuals with sickle cell disease in Texas Medicaid

Background While individuals with sickle cell disease (SCD) experience mental health conditions (MHCs) that may negatively impact health outcomes, studies estimating the prevalence of MHCs in this population are limited.Research design and methods A retrospective analysis of Texas Medicaid data from 01/01/2016-05/31/2021 included individuals aged 3-63 years with SCD and continuously enrolled for one year. Study objectives were addressed using descriptive and bivariate analyses.Results Of the 2878 (mean age = 23.1 ± 14.0) individuals included, 29.9% had at least one MHC. The most common MHCs were substance use disorders (15.4%), depressive disorders (8.4%), anxiety (8.3%), and suicidal ideation (6.1%). While no significant difference in age, those with SCD+MHCs had a significantly higher proportion of males (37.1% vs 27.7%, p < 0.0001). Also, compared to those without MHCs, those with MHCs had a significantly (p < 0.0001) higher mean number and proportion, respectively, of vaso-occlusive crises (5.8 ± 5.8 vs. 1.8 ± 3.1; 82.9% vs. 51.9%), SCD-related complications (3.3 ± 2.3 vs. 1.9 ± 1.8; 92.2% vs. 75.5%), and comorbid medical conditions (1.2 ± 1.2 vs. 0.5 ± 0.9; 65.5% vs. 35.7%).Conclusions Individuals with SCD+MHCs had poorer health outcomes. Timely screening and treatment of MHCs and incorporating mental health specialists into the care team may improve patient outcomes. Interpretation should consider limitations inherent to claims data.