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Published Online: 26 October 2023

Mental Health Care Use by Ethnicity and Preferred Language in a National Cohort of Community Health Center Patients

Elena Byhoff, M.D., M.Sc. [email protected], Dang H. Dinh, M.S., Jennifer A. Lucas, Ph.D., Miguel Marino, Ph.D., and John Heintzman, M.D., M.P.H.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 4
https://doi.org/10.1176/appi.ps.20220585
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Abstract

Objective:

Disparities in U.S. mental health care by race and ethnicity have long been documented. The authors sought to compare specialty mental health service use among non-Hispanic White, English-preferring Hispanic, and Spanish-preferring Hispanic patients who accessed care in community health centers (CHCs).

Methods:

Retrospective electronic medical records data were extracted for patients ages ≥18 years who received care in 2012–2020 at a national CHC network. Zero-inflated Poisson regression models were used to estimate the likelihood of receiving mental health services, which was compared with expected annual rates of mental health service use.

Results:

Of the 1,498,655 patients who received care at a CHC during the study, 14.4% (N=215,098) received any specialty mental health services. English- and Spanish-preferring Hispanic patients were less likely to have had a mental health visit (OR=0.69, 95% CI=0.61–0.77, and OR=0.65, 95% CI=0.54–0.78, respectively). Compared with non-Hispanic White patients, Spanish-preferring Hispanic patients had an estimated annualized rate of 0.59 (95% CI=0.46–0.76) mental health visits.

Conclusions:

Among patients who were likely to receive specialty mental health services, Spanish-preferring patients had a significantly lower rate of mental health care use. Although overall access to mental health care is improving, unequal access to recurring specialty mental health care remains among patients who do not prefer to use English.

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Supplementary Material

File (appi.ps.20220585.ds001.pdf)

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 4 • April 01, 2024
Pages: 363 - 368
PubMed: 37880967

History

Received: 17 November 2022
Revision received: 26 May 2023
Revision received: 1 August 2023
Accepted: 16 August 2023
Published online: 26 October 2023
Published in print: April 01, 2024

Keywords

  1. Hispanics
  2. Primary care
  3. Public policy issues
  4. Racial-ethnic disparities
  5. Utilization patterns and review

Authors

Affiliations

Elena Byhoff, M.D., M.Sc. [email protected]
Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman).
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Dang H. Dinh, M.S.
Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman).
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Jennifer A. Lucas, Ph.D.
Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman).
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Miguel Marino, Ph.D.
Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman).
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John Heintzman, M.D., M.P.H.
Department of Medicine, University of Massachusetts Chan Medical School, Worcester (Byhoff); Department of Family Medicine, Oregon Health & Science University, Portland (Dinh, Lucas, Marino, Heintzman); Department of Research, OCHIN, Portland, Oregon (Heintzman).
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Notes

Send correspondence to Dr. Byhoff ([email protected]).

Competing Interests

Dr. Byhoff reports receiving fees from the Patient-Centered Outcomes Research Institute and Kaiser Permanente. Dr. Heintzman reports being a contract employee with OCHIN, Inc. The other authors report no financial relationships with commercial interests.

Funding Information

Supported by grants from the National Institute on Minority Health and Health Disparities (K23 MD-015267 to Dr. Byhoff and R01 MD-014120 to Mr. Dinh and Drs. Lucas, Marino, and Heintzman).

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