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

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.