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Comprehensive and Integrated Services in Specialty Mental Health Treatment Facilities in the US: Differences by the Racial/Ethnic Composition of the Facility’s Clientele, 2020

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Abstract

The integration of multiple ancillary services into mental health treatment settings may improve outcomes, but there are no national studies addressing whether comprehensive services are distributed equitably. We investigated whether the availability of a wide range of service types differs based on the facility’s racial/ethnic composition. We used the 2020 National Mental Health Services Survey to identify twelve services offered in outpatient mental health treatment facilities (N = 1,074 facilities). We used logistic regression to model each of the twelve services, predicted by the percentage of a facility’s clientele that was White, Black, and Hispanic, adjusted for covariates. Facilities with the highest proportions of Black and Hispanic clientele demonstrated the lowest predicted probabilities of offering comprehensive and integrated services. Our findings offer context around upstream factors that may, in part, drive treatment disparities. We orient our findings around frameworks of structural racism and inequities in mental healthcare.

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Data Availability

This study did not use human subjects or individual-level data. Only publicly available, aggregate, administrative, facility-level data was used.

The N-MHSS dataset is free and publicly available through SAMHSA (https://www.datafiles.samhsa.gov/dataset/national-mental-health-services-survey-2020-n-mhss-2020-ds0001).

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Authors and Affiliations

  1. Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 3401 W. Markham St, Little Rock, AR, 72205, USA

    George Pro, Brooke E. E. Montgomery & Nick Zaller

  2. Criminal Justice Research Center, Fay W. Boozman College of Public Health, Southern Public Health, University of Arkansas for Medical Sciences, 3401 W. Markham St, Little Rock, Arkansas, USA

    George Pro, O’Dell Johnson, Brooke E. E. Montgomery & Nick Zaller

  3. Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 3401 W. Markham St, Little Rock, Arkansas, USA

    Clare C. Brown

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Contributions

GP conceived of the study, analyzed the data, and drafted the first manuscript version. CB assisted with data analysis and provided substantive feedback on all manuscript sections. OJ, BM, and NZ provided substantive feedback on all manuscript sections and provided expert insight around interpreting study results.

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Correspondence to George Pro.

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Pro, G., Brown, C., Johnson, O. et al. Comprehensive and Integrated Services in Specialty Mental Health Treatment Facilities in the US: Differences by the Racial/Ethnic Composition of the Facility’s Clientele, 2020. Community Ment Health J 60, 272–282 (2024). https://doi.org/10.1007/s10597-023-01168-0

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