Examining the effects of ethnic-specific services: An analysis of cost-utilization and treatment outcome for Asian American clients

Abstract

Ethnic-specific mental health services have developed to meet the unique cultural and linguistic needs of the ethnic client. It has been assumed that this type of service configuration provides more accessible, culturally-responsive mental health care, which in turn, encourages utilization and enhances outcomes. Previous studies have found that ethnic-specific services (ESS) increase utilization of mental health services, but there has only been inconsistent evidence that ESS results in better outcomes. This study compared patterns of the cost-utilization and outcomes of Asian American outpatients using ESS to those Asians using mainstream services. Consistent with earlier studies, cost-utilization for ESS Asian clients was higher than that for mainstream Asian clients. Better treatment outcome was found for ESS clients compared to their mainstream counterparts, even after controlling for certain demographics, pretreatment severity, diagnosis, and type of reimbursement. Moreover, there was a significant relationship between cost-utilization and outcome for ESS clients, whereas for mainstream clients, this relationship was not significant. The findings strongly suggest that mental health services with an ethnic-specific focus provide more effective and efficient care for at least one ethnic minority group. Implications for the delivery of culturally-competent mental health services are discussed. © 2000 John Wiley & Sons, Inc.