title: Health Outcomes and Costs Associated with the Provision of Culturally Competent Services for Underrepresented Ethnic Populations with Severe Mental Illness.
abstract: Underrepresented racial/ethnic populations (UREPs) face disparities in their use of behavioral health services for multiple reasons including lack of culturally competent services and stigma. This paper employs mixed methods to compare health outcomes and costs among clients in 14 culturally competent behavioral health programs targeting specific UREPs to five programs without a specific racial or ethnic focus. We found that UREP-focused programs were associated with similar improvements in health outcomes, but greater costs relative to the comparison programs. Main themes from the qualitative analysis included: addressing stigma, building trust and understanding confidentiality, looking for a cure, and moving beyond linguistic competency.
authors.affiliation: University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, USA. tgilmer@ucsd.edu.
authors.forename: Todd
authors.identifier: http://orcid.org/0000-0002-8360-3522
authors.initials: T
authors.lastname: Gilmer
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Henwood
authors.affiliation: Harder & Co, Inc., Los Angeles, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: McGovern
authors.affiliation: University of California, 9500 Gilman Dr., La Jolla, San Diego, CA, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Hurst
authors.affiliation: MedImpact, San Diego, USA.
authors.forename: James
authors.initials: J
authors.lastname: Burgdorf
authors.affiliation: Los Angeles County Department of Mental Health, Los Angeles, USA.
authors.forename: Debbie
authors.initials: D
authors.lastname: Innes-Gomberg
mesh_terms: D000293:Adolescent; D000328:Adult; D003144:Communication Barriers; D000529:Complementary Therapies; D003219:Confidentiality; D003365:Costs and Cost Analysis; D054521:Cultural Competency; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D007802:Language; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D008875:Middle Aged; D012720:Severity of Illness Index; D057545:Social Stigma; D012959:Socioeconomic Factors; D035502:Trust; D055815:Young Adult
keywords: Cost analysis; Cultural-competency; Integrated care; Mental health services; Mixed-methods