Am
J Psychiatry 1992 Mar;149(3):379-84
Racial/ethnic identity and amount and type of psychiatric treatment.
Flaskerud JH, Hu LT.
School of Nursing, University of California, Los Angeles 90024-1702.
OBJECTIVE: The purpose of this study was to examine
the relationship of racial/ethnic identity to the amount and type of psychiatric
treatment received by white, black, Latino, and Asian patients in the
Los Angeles County mental health system.
METHOD: The patients studied (N = 19,400) consisted of
all adult inpatients and outpatients seen in all county mental health
facilities between January 1983 and August 1988. Multiple regression analysis
was used to test the relationship between race/ethnicity and four measures
of treatment received: number of treatment sessions, treatment modality,
treatment setting, and therapist's discipline. The covariates included
in the analyses were age, sex, socioeconomic status, primary language,
diagnosis, and measures of treatment when these were logical predictors
and were not acting as dependent variables.
RESULTS: Race/ethnicity did not have a consistent significant
relationship to the treatment variables studied. However, diagnosis had
a consistent and highly significant relationship to all four measures
of treatment. A psychotic diagnosis was related to receiving more treatment
sessions, greater use of medication, greater use of inpatient treatment,
and less treatment by a professional therapist. Socioeconomic status and
primary language also had consistent and significant relationships to
three of the treatment variables.
CONCLUSIONS: In considering modifications to the service
delivery system, clinicians must evaluate whether the type of treatment
provided to psychotic patients is the treatment of choice in terms of
effectiveness and efficiency or whether it involves bias in service delivery.
Similarly, the issue of bias in treatment of lower socioeconomic patients
must be addressed.
PMID: 1346950 [PubMed - indexed for MEDLINE]