Providers, Places, and Children’s Mental Health Care

Abstract Children’s mental health is the defining public health crisis of our time. Using the largest repository of private insurance claims in the United States, I provide the first systematic quantification of the variation in children’s mental health prescribing in the U.S. I separate variation due to 1) primary care provider (PCP) prescribing intensities, 2) regional practice environments, and 3) child health and demand. Equalizing PCP intensities would reduce the variance of provider prescribing rates by 50 percent for ADHD and 65 percent for antidepressants. Analyzing geographic variation alone significantly understates the extent of treatment variation and the role of providers.