35.1 Adequacy of Children’s Mental Health Services: Variations by Race and Clinical Characteristics

Abstract

ObjectivesThis study utilized an expert consensus approach to determine adequacy of children’s mental health services and examined whether adequacy varied by demographic and/or clinical characteristics.MethodsData were obtained from 687 children aged 6 to 12 years old who had visited 1 of 9 outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Children and their parents were interviewed using the K-SADS and the Service Assessment for Children and Adolescents (SACA) to assess youths’ psychiatric symptoms and lifetime mental health services use, respectively. Analyses employed an expert consensus approach (informed by published treatment guidelines) to determine children’s psychotropic treatment adequacy.ResultsBlack youth (compared to White youth; OR = 2.03; 95% CI, 1.53-2.70), and those with anxiety disorders (vs no anxiety disorder; OR = 1.57; 95% CI, 1.10-2.24) were more likely to receive inadequate care. Youth whose caregivers had a bachelor’s or more advanced degree (vs GED, high school, or less education; OR = 0.71; 95% CI, 0.60-0.83) were less likely to receive inadequate care.ConclusionsUsing the consensus rater approach permitted the use of published treatment efficacy data and patient characteristics (eg, age, diagnoses, history of recent hospitalization, psychotherapy). These results replicate racial disparities found in previous research using traditional methods to determine treatment adequacy (eg, with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.EBP, BRD, DEI ObjectivesThis study utilized an expert consensus approach to determine adequacy of children’s mental health services and examined whether adequacy varied by demographic and/or clinical characteristics. This study utilized an expert consensus approach to determine adequacy of children’s mental health services and examined whether adequacy varied by demographic and/or clinical characteristics. MethodsData were obtained from 687 children aged 6 to 12 years old who had visited 1 of 9 outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Children and their parents were interviewed using the K-SADS and the Service Assessment for Children and Adolescents (SACA) to assess youths’ psychiatric symptoms and lifetime mental health services use, respectively. Analyses employed an expert consensus approach (informed by published treatment guidelines) to determine children’s psychotropic treatment adequacy. Data were obtained from 687 children aged 6 to 12 years old who had visited 1 of 9 outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Children and their parents were interviewed using the K-SADS and the Service Assessment for Children and Adolescents (SACA) to assess youths’ psychiatric symptoms and lifetime mental health services use, respectively. Analyses employed an expert consensus approach (informed by published treatment guidelines) to determine children’s psychotropic treatment adequacy. ResultsBlack youth (compared to White youth; OR = 2.03; 95% CI, 1.53-2.70), and those with anxiety disorders (vs no anxiety disorder; OR = 1.57; 95% CI, 1.10-2.24) were more likely to receive inadequate care. Youth whose caregivers had a bachelor’s or more advanced degree (vs GED, high school, or less education; OR = 0.71; 95% CI, 0.60-0.83) were less likely to receive inadequate care. Black youth (compared to White youth; OR = 2.03; 95% CI, 1.53-2.70), and those with anxiety disorders (vs no anxiety disorder; OR = 1.57; 95% CI, 1.10-2.24) were more likely to receive inadequate care. Youth whose caregivers had a bachelor’s or more advanced degree (vs GED, high school, or less education; OR = 0.71; 95% CI, 0.60-0.83) were less likely to receive inadequate care. ConclusionsUsing the consensus rater approach permitted the use of published treatment efficacy data and patient characteristics (eg, age, diagnoses, history of recent hospitalization, psychotherapy). These results replicate racial disparities found in previous research using traditional methods to determine treatment adequacy (eg, with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.EBP, BRD, DEI Using the consensus rater approach permitted the use of published treatment efficacy data and patient characteristics (eg, age, diagnoses, history of recent hospitalization, psychotherapy). These results replicate racial disparities found in previous research using traditional methods to determine treatment adequacy (eg, with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.