The effects of race and criminal justice involvement on access to atypical antipsychotic medications among persons with schizophrenia.
This study examined the impact of race and arrest history on the likelihood of being prescribed, and maintaining an atypical antipsychotic prescription for 90 or more days among patients with schizophrenia in the community. Participants were 224 adults with schizophrenia-spectrum disorders receiving services in public-sector mental health systems in North Carolina. The data used for this report were from a subsample of a larger group of participants being followed in an observational study and consisted of individuals who were prescribed either an atypical or conventional antipsychotic medication for 90 or more days. The purpose of the analyses presented here was to investigate differences in the likelihood of being prescribed an atypical antipsychotic by demographic and other characteristics. Logistic regression analysis indicated that African American patients were significantly less likely to receive atypical antipsychotics than their white counterparts, even when controlling for key clinical and demographic variables. However, white patients with a history of arrest were no more likely than black patients to receive atypical antipsychotics; that is, minority racial status and criminal involvement each functioned to limit patients' access to the novel medications. Implications for equal access to mental health services, in this case, effective psychopharmacologic treatment, are discussed.
Services Effectiveness Research Program, Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA. richard.vandorn@duke.edu
Richard A
RA
Van Dorn
Jeffrey W
JW
Swanson
Marvin S
MS
Swartz
Eric B
EB
Elbogen
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D003416:Criminal Law / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D009657:North Carolina; D011287:Prejudice; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000208:ethnology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*; D001741:Black or African American
D014150:Antipsychotic Agents