Ethnic disparities in use of public mental health case management services among patients with schizophrenia

Objectives: This study examined case management service use by ethnic group in a sample of 4,249 European-American, Latino, and African-American patients with a diagnosis of schizophrenia or schizoaffective disorder who were receiving services in the public mental health sector of San Diego County during fiscal year 1998-1999. Methods: Data on demographic and clinical variables were obtained from the public mental health services database of the San Diego County Mental Health Department. Multivariate logistic regression analyses were used to determine the relationship between the demographic and clinical variables and use of case management services. Results: The ethnic composition of the sample was 64 percent European American, 20 percent Latino, and 17 percent African American. Overall, 1,100 patients (26 percent) received case management services. A disproportionately greater percentage of service use occurred among European Americans (30 percent) than among patients from ethnic minorities (19 percent for Latinos and 17 percent for African Americans). The results also indicated that Spanish-speaking Latinos underused case management services; however, the underuse was less dramatic than anticipated. Conclusions: The results of this study underscore the need for continuing concern about the use of case management and other mental health services by persons from ethnic minorities.