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Emergency department psychiatric consultation arrangements.

The effects of organizational and environmental factors on emergency department psychiatric consultation arrangements and the influence of arrangement on service effectiveness are examined. The findings have implications for health care researchers, administrators, and policymakers, encouraging further exploration into arrangement type and conditions that produce optimal patient and organizational outcomes.

American Hospital Association↗
PubMed2002

Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites.

OBJECTIVE: The authors investigated whether there are disparities in the rates of specialty mental health care for Latinos and African Americans compared with non-Latino whites in the United States. METHODS: Data were analyzed from the 1990-1992 National Comorbidity Survey, which surveyed a probability sample of 8,098 English-speaking respondents aged 15 to 54 years. Respondents self-identified their race or ethnicity, yielding a sample of 695 Latinos, 987 African Americans, and 6,026 non-Latino whites. Data on demographic characteristics, insurance status, psychiatric morbidity, whether the respondent lived in an urban or a rural area, geographic location, income, and use of mental health services were determined for each ethnic or racial group. Logistic regression analyses were used to examine the associations between ethnic or racial group and use of specialty services, with relevant covariates adjusted for. RESULTS: Significant differences between ethnic groups were found in demographic characteristics, geographic location, zone of residence, insurance status, income, wealth, and use of mental health services. The results indicated that poor Latinos (family income of less than $15,000) have lower access to specialty care than poor non-Latino whites. African Americans who were not classified as poor were less likely to receive specialty care than their white counterparts, even after adjustment for demographic characteristics, insurance status, and psychiatric morbidity. CONCLUSIONS: To understand ethnic or racial disparities in specialty care, the effects of ethnicity or race should be analyzed in combination with variables related to poverty status and environmental context. Further research needs to address the complex construct of social position in order to bridge the gap in unmet need in specialty care.

Adolescent↗
PubMed1981

Financing and demand for mental health services.

This paper surveys the emerging literature on financing and demand for mental health services. Most studies at present simply report the cost experience of members of an insurance pool, and research on demand behavior has been very limited. Nevertheless, some conclusion are possible. First, the responsiveness of demand for outpatient mental health care is greater than the responsiveness of demand for general medical services. Second, demand for mental health services grows over time among members of an insurance pool, even as coverage remains stable. Third, demand of lower income groups is more responsive to insurance than is demand of upper income groups. New research should focus on the effect of financing policy on the choice of setting for care.

Financing, Organized↗