title: Clinician factors related to outcome differences between black and white patients at CMHCs.
abstract: OBJECTIVE
  Data are limited on how clinicians contribute to outcome differences between black patients and white patients. Because the clinician-patient relationship is the foundation of mental health services, understanding clinicians' role in outcome differences may help identify evidence-based interventions that decrease disparities and capitalize on positive differences. Symptoms and functioning in a sample of black and white adults receiving outpatient services were examined to determine the effects of their primary clinician on those patterns.
  
  
  METHODS
  The study included 551 patients (25% black) with serious mental illness and 62 mental health professionals (21% black) identified as the patients' primary clinician. Treatment outcomes were measured at baseline and two follow-ups (two and four months) with the Behavior and Symptom Identification Scale, a measure of symptoms and functioning. Data were analyzed with hierarchical linear modeling. Clinicians' levels of multicultural competence, burnout, and education were analyzed.
  
  
  RESULTS
  Clinicians moderated the relationship between patient race and outcome differences. There was significant variability among clinicians: approximately 20% had black patients whose outcomes were worse than those of their white patients, and 40% had black patients with better outcomes than their white patients. The only clinician factor predicting these differences was clinician's general experiences and relationships with people from racial-ethnic and cultural groups other than their own.
  
  
  CONCLUSIONS
  The occurrence of outcome differences varied across clinicians, with some clinicians magnifying outcome differences between black and white patients and others minimizing them. Factors other than clinicians' race, multicultural competence, education, and burnout may contribute to outcome differences between black and white patients.
authors.affiliation: School of Social Work, Universityof Illinois at Urbana–Champaign, Urbana, IL 61801, USA. larrison@illinois.edu
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Larrison
authors.forename: Susan L
authors.initials: SL
authors.lastname: Schoppelrey
authors.forename: Samantha
authors.initials: S
authors.lastname: Hack-Ritzo
authors.forename: Wynne S
authors.initials: WS
authors.lastname: Korr
mesh_terms: D000328:Adult; D001741:Black or African American; D003155:Community Mental Health Centers; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People