title: Ethnic Disparities in School-Based Behavioral Health Service Use for Children With Psychiatric Disorders.
abstract: We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders.
  
  
  
  Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD], conduct/oppositional defiant disorder, and "other") and by race/ethnicity (African-American, Hispanic, white, and other). Logistic and generalized linear regression analyses were used.
  
  
  
  Differences in service use by racial/ethnic group were identified within and across diagnostic groups, both for in-school service use and out-of-school service use. For all disorders, Hispanic children had significantly lower use of in-school services than white children. Among children with ADHD, African-American children were less likely to receive in-school services than white children; however, there were no differences in adjusted annual mean Medicaid expenditures for in-school services by race/ethnicity or psychiatric disorders. Statistically significant differences by race/ethnicity were found for out-of-school service use for children with ADHD and other psychiatric disorders. There were significant differences by race/ethnicity in out-of-school service use for each diagnostic group.
  
  
  
  Differences in the use of school-based behavioral health services by racial and ethnic groups suggest the need for culturally appropriate outreach and tailoring of services to improve service utilization.
authors.affiliation: University of Washington, Speech and Hearing Sciences, University of Washington Autism Center, Box 357920, Seattle, WA 98195.
authors.forename: Jill
authors.initials: J
authors.lastname: Locke
authors.affiliation: University of Pennsylvania Center for Mental Health Policy and Services Research, Philadelphia, PA 19104.
authors.forename: Christina D
authors.initials: CD
authors.lastname: Kang-Yi
authors.affiliation: University of Pennsylvania Center for Mental Health Policy and Services Research, Philadelphia, PA 19104.
authors.forename: Melanie
authors.initials: M
authors.lastname: Pellecchia
authors.affiliation: Department of Social Policy and Practice, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd floor, Philadelphia, PA 19104.
authors.forename: Steven
authors.initials: S
authors.lastname: Marcus
authors.affiliation: University of Pennsylvania Center for Mental Health Policy and Services Research, Philadelphia, PA 19104.
authors.forename: Trevor
authors.initials: T
authors.lastname: Hadley
authors.affiliation: University of Pennsylvania Center for Mental Health Policy and Services Research, The Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, PA 19104.
authors.forename: David S
authors.initials: DS
authors.lastname: Mandell
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy; D054525:Minority Health / Q000706:statistics & numerical data*; D015143:Philadelphia / Q000453:epidemiology; D012572:School Health Services / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: Medicaid; behavioral health; health disparity; mental health; school-based health services