Racial and ethnic differences in utilization of mental health services among high-risk youths.
OBJECTIVE
Racial and ethnic disparities in mental health service use have been identified as a major public health problem. However, the extent to which these disparities may be accounted for by other confounding sociodemographic or clinical predictors of service use (e.g., family income, functional impairment, caregiver strain) is relatively unexplored, especially for youth services. The goal of this study was to test for racial/ethnic disparities in use of a variety of outpatient, inpatient, and informal mental health services among high-risk youths, with the effects of other predictive factors controlled.


METHODS
Participants were 1,256 youths ages 6-18 years who received services in a large, publicly funded system of care (including the child welfare, juvenile justice, special education, alcohol and drug abuse, and mental health service sectors). Youths and caregivers were interviewed with established measures of mental health service use, psychiatric diagnoses, functional impairment, caregiver strain, and parental depression.


RESULTS
Significant racial/ethnic group differences in likelihood of receiving any mental health service and, specifically, formal outpatient services were found after the effects of potentially confounding variables were controlled. Race/ethnicity did not exert a significant effect on the use of informal or 24-hour-care services.


CONCLUSIONS
Racial/ethnic disparities in service use remain a public health problem.
Child and Adolescent Services Research Center, Children's Hospital and Health Center, 3020 Children's Way (MC 5033), San Diego, CA 92123, USA. agarland@casrc.org
Ann F
AF
Garland
Anna S
AS
Lau
May
M
Yeh
Kristen M
KM
McCabe
Richard L
RL
Hough
John A
JA
Landsverk
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001741:Black or African American / Q000706:statistics & numerical data; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D002648:Child; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011634:Public Health / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data