Racial and Ethnic Differences in Utilization of Mental Health Services Among High-Risk Youths

TLDR

Racial and ethnic disparities in mental health service use are a major public health problem, yet how much they are explained by sociodemographic or clinical factors remains largely unexplored for youth services. This study aimed to test for racial/ethnic disparities in use of outpatient, inpatient, and informal mental health services among high‑risk youths while controlling for other predictive factors. The study analyzed data from 1,256 youths aged 6–18 who received services across multiple publicly funded sectors, using interviews and established measures of service use, psychiatric diagnoses, functional impairment, caregiver strain, and parental depression. After adjusting for confounders, significant racial/ethnic differences remained in overall service use and formal outpatient services, but not in informal or 24‑hour‑care services, indicating persistent disparities.

Abstract

OBJECTIVE: Racial and ethnic disparities in mental health service use have been identified as a major public health problem. However, the extent to which these disparities may be accounted for by other confounding sociodemographic or clinical predictors of service use (e.g., family income, functional impairment, caregiver strain) is relatively unexplored, especially for youth services. The goal of this study was to test for racial/ethnic disparities in use of a variety of outpatient, inpatient, and informal mental health services among high-risk youths, with the effects of other predictive factors controlled. METHOD: Participants were 1,256 youths ages 6–18 years who received services in a large, publicly funded system of care (including the child welfare, juvenile justice, special education, alcohol and drug abuse, and mental health service sectors). Youths and caregivers were interviewed with established measures of mental health service use, psychiatric diagnoses, functional impairment, caregiver strain, and parental depression. RESULTS: Significant racial/ethnic group differences in likelihood of receiving any mental health service and, specifically, formal outpatient services were found after the effects of potentially confounding variables were controlled. Race/ethnicity did not exert a significant effect on the use of informal or 24-hour-care services. CONCLUSIONS: Racial/ethnic disparities in service use remain a public health problem.