Administration and Policy in Mental Health and Mental Health Services Research

, Volume 26, Issue 2, pp 101-109

First online:

Racial/Ethnic Disparities in Admissions to Public and Private Psychiatric Inpatient Settings: The Effect of Managed Care

  • Kermit CrawfordAffiliated withBoston University School of Medicine
  • , William H. FisherAffiliated withUniversity of Massachusetts Medical School
  • , Melissa McDermeitAffiliated withUniversity of Massachusetts Medical School

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This study investigates the effect of managed care on access patterns among people of color who are severely and persistently mentally ill. The distribution of admissions to public and private psychiatric hospitals was compared for African-American, Asian, Latino, and white case managed clients of the Massachusetts Department of Mental Health before and after implementation of Medicaid managed mental health care in October 1997. Managed care appears to have increased access to private services across all racial and ethnic groups, although admissions of non-white patients were still more likely to take place in publicly operated settings. These data suggest that equalizing access to putatively better inpatient treatment settings may be an externality of managed care.