Racial and ethnic differences in utilization of mental health services among high-risk youths

Am J Psychiatry. 2005 Jul;162(7):1336-43. doi: 10.1176/appi.ajp.162.7.1336.


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.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • African Americans / statistics & numerical data
  • Ambulatory Care / statistics & numerical data
  • Asian Americans / statistics & numerical data
  • Child
  • Community Mental Health Services / statistics & numerical data*
  • Continental Population Groups / statistics & numerical data*
  • Ethnic Groups / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Hispanic Americans / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Psychiatric Status Rating Scales
  • Public Health / statistics & numerical data
  • Risk Factors
  • United States / ethnology