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Lonnie R. Snowden, PhD, Mary C. Masland, PhD, Anne M. Libby, PhD, Neal Wallace, PhD and Kya Fawley, MSW

Lonnie R. Snowden, Mary C. Masland, and Kya Fawley are with the Center for Mental Health Services Research, School of Social Welfare, University of California, Berkeley. Anne M. Libby is with the Department of Psychiatry, School of Medicine, University of Colorado, Denver, and Health Sciences Center, Denver. Neal Wallace is with the Mark O. Hatfield School of Government, Portland State University, Portland, Ore.

Correspondence: Requests for reprints should be sent to Lonnie R. Snowden, 120 Haviland Hall, University of California, Berkeley, CA 94720-7400 (e-mail: snowden{at}berkeley.edu).

Objectives. We examined rates and intensity of crisis services use by race/ethnicity for 351174 children younger than 18 years who received specialty mental health care from California’s 57 county public mental health systems between July 1998 and June 2001.

Methods. We used fixed-effects regression for a controlled assessment of racial/ethnic disparities in children’s use of hospital-based services for the most serious mental health crises (crisis stabilization services) and community-based services for other crises (crisis intervention services).

Results. African American children were more likely than were White children to use both kinds of crisis care and made more visits to hospital-based crisis stabilization services after initial use. Asian American/Pacific Islander and American Indian/Alaska Native children were more likely than were White children to use hospital-based crisis stabilization services but, along with Latino children, made fewer hospital-based crisis stabilization visits after an initial visit.

Conclusions. African American children used both kinds of crisis services more than did White children, and Asian Americans/Pacific Islander and American Indians/Alaska Native children visited only when they experienced the most disruptive and troubling kind of crises, and made nonrecurring visits.