The Potential to Reduce Mental Health Disparities Through the Comprehensive Community Mental Health Services for Children and Their Families Program

  • Richard Miech
  • Melissa Azur
  • Tracy Dusablon
  • Keri Jowers
  • Amy B. Goldstein
  • Elizabeth A. Stuart
  • Christine Walrath
  • Philip J. Leaf
Regular Article

Abstract

Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race–ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997 to 2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all Children’s Mental Health Initiative communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized.

Keywords

disparities systems of care children’s mental health services 

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Copyright information

© National Council for Community Behavioral Healthcare 2008

Authors and Affiliations

  • Richard Miech
    • 1
  • Melissa Azur
    • 2
  • Tracy Dusablon
    • 2
  • Keri Jowers
    • 2
  • Amy B. Goldstein
    • 3
  • Elizabeth A. Stuart
    • 2
    • 4
  • Christine Walrath
    • 5
    • 7
    • 8
  • Philip J. Leaf
    • 2
    • 6
  1. 1.Department of Health and Behavioral SciencesUniversity of Colorado at Denver and Health Sciences CenterDenverUSA
  2. 2.Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Child and Adolescent Preventive Intervention ProgramNational Institute of Mental HealthRockvilleUSA
  4. 4.Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  5. 5.Macro International Inc.New YorkUSA
  6. 6.Department of PsychiatryJohns Hopkins School of MedicineBaltimoreUSA
  7. 7.Johns Hopkins University Bloomberg School of Public HealthBaltimoreUSA
  8. 8.University of Maryland Baltimore CountyCatonsvilleUSA

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