Comprehensive and Integrated Services in Specialty Mental Health Treatment Facilities in the US: Differences by the Racial/Ethnic Composition of the Facility's Clientele, 2020

Community Ment Health J. 2024 Feb;60(2):272-282. doi: 10.1007/s10597-023-01168-0. Epub 2023 Jul 12.


The integration of multiple ancillary services into mental health treatment settings may improve outcomes, but there are no national studies addressing whether comprehensive services are distributed equitably. We investigated whether the availability of a wide range of service types differs based on the facility's racial/ethnic composition. We used the 2020 National Mental Health Services Survey to identify twelve services offered in outpatient mental health treatment facilities (N = 1,074 facilities). We used logistic regression to model each of the twelve services, predicted by the percentage of a facility's clientele that was White, Black, and Hispanic, adjusted for covariates. Facilities with the highest proportions of Black and Hispanic clientele demonstrated the lowest predicted probabilities of offering comprehensive and integrated services. Our findings offer context around upstream factors that may, in part, drive treatment disparities. We orient our findings around frameworks of structural racism and inequities in mental healthcare.

Keywords: Health service research; Mental health; Public health; Race & ethnicity; Social epidemiology.

MeSH terms

  • Black or African American
  • Healthcare Disparities
  • Hispanic or Latino
  • Hospitals, Psychiatric
  • Humans
  • Mental Health Services*
  • Mental Health*
  • Racial Groups
  • United States
  • White