Service Utilization Before and After Self-Direction: A Quasi-experimental Difference-in-Differences Analysis of Utah’s Mental Health Access to Recovery Program

Mental health self-direction involves participant control of an individualized budget to support recovery and wellness goals. This quasi-experimental study examined whether self-direction is associated with changes in service utilization. The study involved 2 years of administrative data for 94 self-directing participants and a matched comparison group of 529 non-participants with similar observed characteristics. Difference-in-differences were examined using four regression models predicting changes in four service utilization categories. Self-directing participants had greater increases in outpatient and rehabilitation services than the non-self-directing group, controlling for relevant covariates. There were no between-group differences in residential and emergency service utilization.