189389 Community Correlates of Access to Mental Health Services Among Latinos and Whites

Monday, October 27, 2008: 1:06 PM

Teresa Doksum, PhD , Cambridge Health Alliance, Center for Multicultural Mental Health Research, Somerville, MA
Jing Guo, MS , Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA
Pinka Chatterji, PhD , Economics Department, University at Albany, State University of New York, Albany, NY
Mara Laderman , Cambridge Health Alliance, Center for Multicultural Mental Health Research, Somerville, MA
Benjamin L. Cook, PhD , Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA
Shan Gao, MS , Cambridge Health Alliance, Center for Multicultural Mental Health Research, Somerville, MA
Margarita Alegria, PhD , Psychiatry--Center for Multicultural MH Research, Harvard Medical School, Somerville, MA
Despite documented disparities in utilization and quality of mental health services as well as geographic differences in the availability of mental health professionals, few studies have examined community-level factors associated with access to mental health services for Latinos. To identify ethnic differences in community characteristics associated with use of mental health services in a national sample of Latinos and Whites, we pooled data from the Collaborative Psychiatric Epidemiological Studies (CPES) and linked these data with provider supply and socioeconomic conditions from the Area Resource File and HMO penetration from InterStudy. Multilevel modeling was used to examine ethnic differences in the association between county-level characteristics and self-reported past year use of 1) any mental health services and 2) specialty mental health services. All models controlled for demographic characteristics and mental health status. Use of any mental health services by Latinos was positively associated with the presence of a community mental health center. Use of specialty mental health services was positively associated with density of specialty mental health providers (for both Whites and Latinos) and HMO penetration (for Whites only). Disparities in access to mental health services among Latinos may be reduced by ensuring community mental health centers and specialists are available in their communities, although the quality and intensity of services should also be examined. Further work is needed to investigate how access to mental health services is affected by managed care and the socioeconomic conditions in a community.

Learning Objectives:
Describe how community-level factors may contribute to mechanisms of disparities in mental health services for Latinos; Identify publicly available datasets of community-level factors to link with individual-level survey data on mental health services disparities; Apply multi-level modeling techniques to clustered survey data to address research question on health services disparities.

Keywords: Latino Mental Health, Geocoding

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted analyses for this paper and have over 20 years experience doing health services research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.