Differences in School-Based Referrals for Mental Health Care: Understanding Racial/Ethnic Disparities Between Asian American and Latino Youth

School-based mental health services (SBMHS) are thought to reduce access barriers and disparities in care. This study explores whether there is parity or disparity in SBMHS referral and receipt between two ethnic minority groups and identifies explanations for observed differences. Asian American and Latino students from one urban school district completed a mental health survey at the beginning of the 2010-2011 academic year assessing behavior problems and impairment. Information regarding SBMHS referral and receipt were obtained at end of the school year. Latino youth were more than 4 times more likely to be referred to SBMHS than Asian Americans. Differences in referral likelihood were partially mediated by externalizing problems, school bonding, impairment, and academic performance. However, a statistically significant direct effect of race/ethnicity remained to predict referral even after accounting for these factors. Following referral, no racial/ethnic differences were found in acceptance and receipt of treatment. These findings suggest that usual referral processes through SBMHS gatekeepers may still result in disparities in care despite equivalent access, with Asian Americans more likely to have needs unmet. However, once referred, Latino and Asian students appear to face few barriers in receiving care in schools.