title: Use and quality of mental health services for Haitian youth.
abstract: OBJECTIVE
  To describe the mental health service use of Haitian, African-American, and non-Latino White youth in a community mental health setting. Groups are compared on adherence to treatment guidelines for attention-deficit/hyperactivity disorder (ADHD) and depressive disorders.
  
  
  METHODS
  Retrospective review of outpatient mental health charts (n = 252) from five community sites in an urban area of the Northeastern United States. We recorded the total number and treatment type of sessions during the first six months of treatment. Guideline-adherent treatments were compared and predicted after controlling for clinical need.
  
  
  RESULTS
  Most Haitian and African-American youth stopped treatment by six months, with the majority attending less than eight sessions. One third of Haitian and African-American patients attended just one session. Haitian patients who presented with less severe symptoms and dysfunction were more likely to have single-session treatments. Guideline-adherent treatment for ADHD and depression was less likely for Haitians. Older patients were more likely to receive adequate depression treatment. Haitian youth were relatively underinsured, had more family separations documented, and received Adjustment Disorder diagnoses more often.
  
  
  CONCLUSIONS
  Haitian youth use outpatient mental health services in similar proportion to African-American youth and at lower rates than White youth. Guideline-adherent treatment for ADHD and depression is limited by low retention in care for Black youth. Low insurance coverage is likely an important contributor to reduced use of services, especially for Haitians. These findings are discussed in the context of providing culturally sensitive mental health care to diverse communities.
authors: Center for Multicultural Mental Health Research, 120 Beacon Street, 4th floor, Somerville, MA 02143, USA. ncarson@charesearch.org
authors: Nicholas J
authors: NJ
authors: Carson
authors: Mark
authors: M
authors: Stewart
authors: Julia Y
authors: JY
authors: Lin
authors: Margarita
authors: M
authors: Alegria
mesh_terms: D000275:Adjustment Disorders / Q000188:drug therapy*; D000293:Adolescent; D001741:Black or African American / Q000208:ethnology / Q000706:statistics & numerical data; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D018864:Cultural Diversity; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D019983:Guideline Adherence; D006205:Haiti / Q000208:ethnology; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data* / Q000600:supply & distribution; D008960:Models, Psychological; D010045:Outpatients; D017410:Practice Guidelines as Topic; D011594:Psychometrics; D011787:Quality of Health Care; D012189:Retrospective Studies; D014481:United States; D014505:Urban Population; D044465:White People / Q000208:ethnology / Q000706:statistics & numerical data; D055815:Young Adult