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Am J Psychiatry 1992; 149:379-384
Copyright © 1992 by American Psychiatric Association
Racial/ethnic identity and amount and type of psychiatric treatment
JH Flaskerud and LT Hu
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.
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