title: Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.
abstract: OBJECTIVE
  We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities.
  
  
  METHODS
  Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences.
  
  
  RESULTS
  When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities.
  
  
  CONCLUSIONS
  Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.
authors.affiliation: School of Public Health, University of California, Berkeley, CA 94720-7360, USA. snowden@berkeley.edu
authors.forename: Lonnie R
authors.initials: LR
authors.lastname: Snowden
authors.forename: Sean R
authors.initials: SR
authors.lastname: McClellan
mesh_terms: D002140:California; D003156:Community Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D006291:Health Policy; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007802:Language; D008484:Medicaid / Q000458:organization & administration; D014481:United States