Referral sources, diagnoses, and service types of youth in public outpatient mental health care: A focus on ethnic minorities

Yeh, May; McCabe, Kristen M.; Hurlburt, Michael S.; Hough, Richard L.; Hazen, Andrea L.; Culver, Shirley; Garland, Ann F.; Landsverk, John

doi:10.1007/bf02287831

Cited by 110 publications

(93 citation statements)

References 27 publications

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“…Several other studies have reported similar findings (Roberts and Cawthorpe, 1995;Yeh, McCabe et al, 2002).…”

supporting

confidence: 75%

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Ethnic minority populations and child psychiatry services: An Irish study

Skokauskas

Dunne²,

Gallogly³

et al. 2010

Children and Youth Services Review

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“…Several other studies have reported similar findings (Roberts and Cawthorpe, 1995;Yeh, McCabe et al, 2002).…”

supporting

confidence: 75%

“…Such information may inform the allocation of resources to promote service access and to meet unique service needs of specific groups in the effort to provide effective treatment to all populations (Yeh et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Ethnic minority populations and child psychiatry services: An Irish study

Skokauskas

Dunne²,

Gallogly³

et al. 2010

Children and Youth Services Review

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“…One explanation for discrepant rates could be due to differences in the prevalence of psychiatric conditions. However, studies examining the prevalence of diagnoses among children and adolescents have found comparable (Costello et al, 1996) or in some cases higher (Bird, 1996;Glover et al, 1999;Shaffer et al, 1996;Yeh et al, 2002) rates of psychiatric conditions among African Americans and/or Latinos. Although white children appeared to show higher rates of diagnoses in this sample, this likely does not account for the pattern of findings, as diagnostic status as measured by the DISC was controlled for in analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Findings for African-American children have been mixed, with some finding overrepresentation (Bui and Takeuchi, 1992;Cheung and Snowden, 1990;McCabe et al, 1999;Yeh et al, 2002) and others finding underrepresentation (Bussing et al, 1998b;Cuffe et al, 1995;Pumariega et al, 1993).…”

mentioning

confidence: 99%

Racial/Ethnic Differences in the Use of Psychotropic Medication in High-Risk Children and Adolescents

Leslie

Weckerly

Landsverk

et al. 2003

Journal of the American Academy of Child & Adolescent Psych

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Objectives-To investigate rates of psychotropic medication use by youths served in public service sectors as a function of race/ethnicity.Method-Logistic regression models were used to examine racial/ethnic differences in caregiver report of psychotropic medication use for a random stratified sample of 1,342 children who were served in public service sectors during the second half of fiscal year 1996-97.Results-Race/ethnicity predicted caregiver report of past-year and lifetime psychotropic medication use when all other factors were held constant. Specifically, caregivers of AfricanAmerican and Latino children were less likely to report past-year use compared to white children; caregivers of Latino children and "others" were less likely to report lifetime use. Additional factors predictive of medication use in regression models included younger age, male gender, higher household income, insurance type, active to mental health sector at time of enumeration into the study, impairment and diagnosis of mood, and anxiety or attentional disorder.Conclusions-Racial/ethnic differences in use of psychotropic medication occur in children served in public service sectors and need to be considered in clinical diagnosis and treatment.

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“…For example, if 60% of enrollees have a preference for condition A and 40% have a preference for condition B, then, with true equivalence across conditions, service A would have 60% pleased and 40% disappointed assignees, while service B would have 40% pleased and 60% disappointed assignees. To the extent that participant satisfaction or disappointment influences service engagement and study outcomes (3,4), research findings will be biased in spite of random assignment (5-7).Previous experience with mental health services may influence applicants' attitudes toward research participation and the experimental services offered by a study (8,9). Applicants referred by agencies not designed to provide continuity in outpatient care (e.g., homeless shelters, emergency units) are typically more receptive to a study offering any type of continuous care than are applicants referred by mental health centers (10,11).…”

mentioning

confidence: 99%

Impact of Referral Source and Study Applicants’ Preference for Randomly Assigned Service on Research Enrollment, Service Engagement, and Evaluative Outcomes

Macias¹,

Barreira²,

Hargreaves³

et al. 2005

AJP

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Objective-The inability to blind research participants to their experimental conditions is the Achilles' heel of mental health services research. When one experimental condition receives more disappointed participants, or more satisfied participants, research findings can be biased in spite of random assignment. The authors explored the potential for research participants' preference for one experimental program over another to compromise the generalizability and validity of randomized controlled service evaluations as well as cross-study comparisons.Method-Three Cox regression analyses measured the impact of applicants' service assignment preference on research project enrollment, engagement in assigned services, and a service-related outcome, competitive employment.Results-A stated service preference, referral by an agency with a low level of continuity in outpatient care, and willingness to switch from current services were significant positive predictors of research enrollment. Match to service assignment preference was a significant positive predictor of service engagement, and mismatch to assignment preference was a significant negative predictor of both service engagement and employment outcome.Conclusions-Referral source type and service assignment preference should be routinely measured and statistically controlled for in all studies of mental health service effectiveness to provide a sound empirical base for evidence-based practice.Participants in research on mental health services are rarely blind to their experimental assignments, and so attrition caused by disappointment in service assignment is a wellrecognized risk. Researchers can minimize overall attrition, as well as the threat of differential attrition (1), by screening out applicants with a priori service preferences. However, some applicants may choose not to disclose their preference to ensure that they have a chance to be assigned to a favored program, or they may feel they do not have a personal preference over and above the obvious one posed by the study design. For instance, when the experimental comparison is between a new intervention and services as usual, many applicants may prefer the new program even before they learn much about it.Unfortunately, random assignment will not always equalize preexisting study enrollee characteristics across experimental groups (2), and this will always be the case when study NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript enrollees tend to prefer one service condition over another. Common sense tells us that service assignment preference must first be balanced within the total enrollee group for it to be distributed equitably across experimental conditions. For example, if 60% of enrollees have a preference for condition A and 40% have a preference for condition B, then, with true equivalence across conditions, service A would have 60% pleased and 40% disappointed assignees, while service B would have 40% pleased and 60% disappointed assignees. To the extent that pa...

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Referral sources, diagnoses, and service types of youth in public outpatient mental health care: A focus on ethnic minorities

Cited by 110 publications

References 27 publications

Ethnic minority populations and child psychiatry services: An Irish study

Ethnic minority populations and child psychiatry services: An Irish study

Racial/Ethnic Differences in the Use of Psychotropic Medication in High-Risk Children and Adolescents

Impact of Referral Source and Study Applicants’ Preference for Randomly Assigned Service on Research Enrollment, Service Engagement, and Evaluative Outcomes

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