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Ethnic populations in public mental health: services choice and level of use.

T W Hu, L R Snowden, J M Jerrell and T D Nguyen

School of Public Health, University of California, Berkeley 94720.

BACKGROUND. Barriers to access and use of mental health care by Asians, Blacks, and Hispanic Americans have been a source of concern for many years. Limitations in our knowledge base persist regarding patterns of use in public sector programs of certain services. Using a sample of almost 27,000 persons, this study examined access and level of use by ethnic minority groups of emergency services, inpatient care, individual outpatient visit, and case management. METHODS. Data from the management information systems of San Francisco and Santa Clara counties were analyzed for fiscal year 1987/1988. Multivariate models were evaluated at two stages, reflecting whether or not a service had been used, and if used, the level of use. RESULTS. Asians and Hispanics used less emergency and inpatient but more outpatient care than did Whites; Blacks used more emergency and less outpatient care. CONCLUSIONS. Ethnicity continues to play a role in understanding the utilization of mental health services. Regarding emergency and inpatient care, Asian and Hispanic patterns of use appear relatively favorable, whereas the patterns of Blacks continue to be problematic.

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