title: Ethnic matching of clients and clinicians and use of mental health services by ethnic minority clients.
abstract: OBJECTIVE
  Research in the United States has indicated that matching clients from a minority group with clinicians from the same ethnic background increases use of community mental health services and reduces use of emergency services. This study assessed the effects of matching clients from a non-English-speaking background with bilingual, bicultural clinicians in a mental health system in Australia that emphasizes community-based psychiatric case management.
  
  
  METHODS
  In an overall sample of 2,935 clients served in the western region of Melbourne from 1997 to 1999, ethnic minority clients from a non-English-speaking background who received services from a bilingual, bicultural case manager were compared with ethnic minority clients who did not receive such services and with clients from an English-speaking background. The clients' engagement with three types of services-community care teams, psychiatric crisis teams, and psychiatric inpatient services-was assessed.
  
  
  RESULTS
  Compared with ethnic minority clients who were not matched with a bilingual clinician, those who were matched generally had a longer duration and greater frequency of contact with community care teams and a shorter duration and lower frequency of contact with crisis teams. Clients born in Vietnam who were matched with a bilingual clinician had a shorter annual mean length of hospital stay and a lower annual mean frequency of hospital admission than Australian-born clients.
  
  
  CONCLUSIONS
  The benefits of matching clients with psychiatric case managers on the basis of ethnic background include a lower level of need for crisis intervention and, for clients from some ethnic groups, fewer inpatient interventions. These Australian results support findings of the effectiveness of client-clinician ethnic matching in the United States.
authors.affiliation: Victorian Transcultural Psychiatry Unit, St. Vincent's Hospital, Bolte Wing, Nicholson Street, Fitzroy, Victoria 3065, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ziguras
authors.forename: Steven
authors.initials: S
authors.lastname: Klimidis
authors.forename: James
authors.initials: J
authors.lastname: Lewis
authors.forename: Geoff
authors.initials: G
authors.lastname: Stuart
mesh_terms: D000341:Affective Disorders, Psychotic / Q000208:ethnology* / Q000628:therapy; D019090:Case Management / Q000145:classification* / Q000592:standards; D003144:Communication Barriers; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019303:Multilingualism; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010348:Patient Care Team; D011369:Professional-Patient Relations; D012044:Regression Analysis; D014600:Utilization Review; D014739:Victoria; D000078329:Workforce