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J Sch Health. 2017 Jan;87(1):47-54. doi: 10.1111/josh.12469.

Ethnic Disparities in School-Based Behavioral Health Service Use for Children With Psychiatric Disorders.

Author information

1
University of Washington, Speech and Hearing Sciences, University of Washington Autism Center, Box 357920, Seattle, WA 98195.
2
University of Pennsylvania Center for Mental Health Policy and Services Research, Philadelphia, PA 19104.
3
Department of Social Policy and Practice, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3rd floor, Philadelphia, PA 19104.
4
University of Pennsylvania Center for Mental Health Policy and Services Research, The Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, PA 19104.

Abstract

BACKGROUND:

We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders.

METHODS:

Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD], conduct/oppositional defiant disorder, and "other") and by race/ethnicity (African-American, Hispanic, white, and other). Logistic and generalized linear regression analyses were used.

RESULTS:

Differences in service use by racial/ethnic group were identified within and across diagnostic groups, both for in-school service use and out-of-school service use. For all disorders, Hispanic children had significantly lower use of in-school services than white children. Among children with ADHD, African-American children were less likely to receive in-school services than white children; however, there were no differences in adjusted annual mean Medicaid expenditures for in-school services by race/ethnicity or psychiatric disorders. Statistically significant differences by race/ethnicity were found for out-of-school service use for children with ADHD and other psychiatric disorders. There were significant differences by race/ethnicity in out-of-school service use for each diagnostic group.

CONCLUSIONS:

Differences in the use of school-based behavioral health services by racial and ethnic groups suggest the need for culturally appropriate outreach and tailoring of services to improve service utilization.

KEYWORDS:

Medicaid; behavioral health; health disparity; mental health; school-based health services

PMID:
27917490
PMCID:
PMC5142755
DOI:
10.1111/josh.12469
[Indexed for MEDLINE]
Free PMC Article

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