Exploring Service Use Disparities among Suicidal Black Youth in a Suicide Prevention Care Coordination Intervention

Michelle M Vance; Kim Gryglewicz; Eunji Nam; Sonyia Richardson; Lisa Borntrager; Marc S Karver

doi:10.1007/s40615-022-01402-7

Exploring Service Use Disparities among Suicidal Black Youth in a Suicide Prevention Care Coordination Intervention

J Racial Ethn Health Disparities. 2023 Oct;10(5):2231-2243. doi: 10.1007/s40615-022-01402-7. Epub 2022 Sep 13.

Authors

Michelle M Vance¹, Kim Gryglewicz², Eunji Nam³, Sonyia Richardson⁴, Lisa Borntrager², Marc S Karver⁵

Affiliations

¹ Department of Social Work & Sociology, North Carolina Agricultural & Technical State University, Greensboro, NC, USA. mmvance1@ncat.edu.
² School of Social Work, University of Central Florida, Orlando, FL, USA.
³ School of Social Welfare, Incheon National University, Incheon, South Korea.
⁴ School of Social Work, University of North Carolina at Charlotte, Charlotte, NC, USA.
⁵ Department of Psychology, University of South Florida, Tampa, FL, USA.

PMID: 36100810
DOI: 10.1007/s40615-022-01402-7

Abstract

Objective: The aim of this study is to examine service utilization disparities among Black youth participating in Linking Individuals Needing Care (LINC), a 90-day research-informed suicide care coordination intervention.

Methods: An open trial pilot was conducted to examine the effectiveness of LINC in increasing access to and engagement in mental health and non-mental health services among suicidal youth (N = 587). Other variables of interest included service use facilitators and service use barriers. Generalized linear mixed models with binomial distribution and logit link were performed to ascertain if service use facilitators and barriers were associated with service utilization and if disparities in service use and engagement existed between Black and White suicidal youth through a comparative analysis.

Results: Service utilization differences were found between Black and White youth. While Black and White youth were both likely to engage in individual therapy (OR = 1.398, p < .001) and non-mental health services (OR = 1.289, p < .001), utilization rates for mental health and medication management services were lower for Black (55.1% to 60.6%) youth compared to White (66.0% to 71.0%) youth. Specifically, Black youth were significantly less likely than Whites to receive medication management (OR = .466, p = .002). Systemic barriers such long waitlists for care (OR = 1.860, p = .039) and poor relationship with providers (OR = 7.680, p = .028) increased odds of engagement in non-mental health services. Clinical disorders and engagement in suicide-related behaviors increased the likelihood of obtaining care from both medication management and non-mental health services.

Conclusion: Care coordination services for suicidal youth can increase access and engagement in mental health and non-mental health services. Culturally adapted models attending to cultural and social assets of Black families are needed to reduce disparities and suicide risk among Black youth.

Keywords: Black youth; Care coordination; Disparities; Service utilization; Suicide.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adolescent
Black or African American
Humans
Mental Health
Patient Acceptance of Health Care* / statistics & numerical data
Suicidal Ideation*
Suicide Prevention*
White

Grants and funding

U79 SM061748/SU/SAMHSA HHS/United States