Ethnic Disparities in School-Based Behavioral Health Service Use for Children With Psychiatric Disorders.
Jill Locke, Christina D Kang-Yi, Melanie Pellecchia and 3 others
PMID 27917490WHAT IT FOUND
Hispanic Medicaid-enrolled children with psychiatric disorders were less likely than White children to receive one-to-one behavioral support in school.
African-American children with ADHD used more in-school support but less out-of-school mental health care.
Key findings
01Hispanic Medicaid-enrolled children were less likely than White children to use in-school individual behavioral health services for autism, conduct/ODD, ADHD and other psychiatric disorders.
02African-American Medicaid-enrolled children with ADHD were 62% more likely than White children with ADHD to use in-school services, but 58% less likely to use out-of-school services.
03After age and sex adjustment, out-of-school Medicaid spending estimates were lower for Hispanic children and higher for African-American children with ADHD than for White children.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was limited to Medicaid-enrolled children in Philadelphia who used behavioral health services. The analysis was based on one year of claims data, so it cannot show why disparities occurred or whether they apply to other places. The data did not include other funding sources such as education, private insurance, or out-of-pocket care. Family language was not recorded, so language barriers could not be measured directly. The study could not tell whether schools also provided counseling or medication management. Medicaid spending reflected the volume of service use, not the quality of care.
The easy way to misread this
Do not read lower Hispanic use of in-school services as evidence that Hispanic children need less behavioral health care. The study looked at claims for children who already used services and did not measure unmet need, service quality, or family preferences.