The potential to reduce mental health disparities through the comprehensive community mental health services for children and their families program.
Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race-ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997 to 2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all Children's Mental Health Initiative communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized.
Department of Health and Behavioral Sciences, University of Colorado at Denver and Health Sciences Center, Campus Box 188, P.O. Box 173364, Denver, CO 80217-3364, USA. rmiech@gmail.com
Richard
R
Miech
Melissa
M
Azur
Tracy
T
Dusablon
Keri
K
Jowers
Amy B
AB
Goldstein
Elizabeth A
EA
Stuart
Christine
C
Walrath
Philip J
PJ
Leaf
D000293:Adolescent; D016497:Adolescent Health Services; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003156:Community Mental Health Services; D005192:Family Health; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D011203:Poverty; D014481:United States