Top

Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-05-2014 | Original Article

Racial/Ethnic Disparities in Children’s Emergency Mental Health After Economic Downturns

Authors: Tim Bruckner, Yonsu Kim, Lonnie Snowden

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 3/2014

Abstract

African American children—more than other race/ethnicities—rely on emergency psychiatric care. One hypothesized cause of this overrepresentation involves heightened sensitivity to economic downturns. We test whether the African American/white difference in psychiatric emergency visits increases in months when the regional economy contracts. We applied time-series methods to California Medicaid claims (1999–2008; N = 7.1 million visits). One month following mass layoffs, African American youths use more emergency mental health services than do non-Hispanic whites. Economic downturns may provoke or uncover mental disorder especially among African American youth who by and large do not participate in the labor force.

12.427 layoffs (in thousands) * 0.87 more visits per 1,000 layoffs = 10.81; maximum monthly African American/white disparity is 134; 10.81 more visits/134 = 8.1%.

Acs, G., & Loprest, P. (2007). TANF caseload composition and leavers synthesis report (No. Contract number 233-02-0092 Task order number HHSP23300013T). Washington, DC: Urban Institute.

Atdjian, S., & Vega, W. (2005). Disparities in mental health treatment in US racial and ethnic minority groups: implications for psychiatrists. Psychiatric Services, 56(12), 1600–1602.PubMedCrossRef

Bocian, D., Li, L., Ernst, K. (2010). Foreclosure by race and ethnicity: the demographics of a crisis: center for responsible lending. from http://www.responsiblelending.org/mortgage-lending/research-analysis/foreclosures-by-race-and-ethnicity.html. Accessed 5 Nov 2012.

Box, G., Jenkins, G., & Reinsel, G. (1994). Time series analysis: forecasting and control (3rd ed.). London: Prentice Hall.

Bruckner, T. (2008). Economic antecedents of prone infant sleep placement among black mothers. Annals of Epidemiology, 18(9), 678–681.PubMedCrossRef

Bruckner, T., Snowden, L., Subbaraman, M., & Brown, T. (2010). Economic antecedents of Medicaid financed mental health services among youth in California. International Journal of Mental Health, 39, 75–91.CrossRef

California Department of Mental Health. from http://www.dmh.ca.gov/services_and_programs/children_and_youth/EPSDT.asp. Accessed 15 Nov 2012.

Catalano, R., Goldman-Mellor, S., Saxton, K., Margerison-Zilko, C., & Anderson, E. (2011). The health effects of economic decline. Annual Review of Public Health, 32, 431–450.PubMedCrossRef

Catalano, R., Rook, K., & Dooley, D. (1986). Labor markets and help-seeking: a test of the employment security hypothesis. Journal of Health and Social Behavior, 27, 277–287.PubMedCrossRef

Catalano, R., & Serxner, S. (1987). Time series designs of potential interest to epidemiologists. American Journal of Epidemiology, 126(4), 724–731.PubMed

Catalano, R., Snowden, L., Shumway, M., & Kessell, E. (2007). Unemployment and civil commitment: a test of the intolerance hypothesis. Aggressive Behavior, 33, 272–280.PubMedCrossRef

Chang, I., Tiao, G., & Chen, C. (1988). Estimation of time series parameters in the presence of outliers. Technometrics, 30, 193–204.CrossRef

Dooley, D., & Catalano, R. (1984). Why the economy predicts help-seeking: a test of competing explanations. Journal of Health and Social Behavior, 25, 160–176.PubMedCrossRef

Dua, P., & Smyth, D. (1993). Survey evidence on excessive public pessimism about the future behavior of unemployment. Public Opinion Quarterly, 57, 566–574.CrossRef

Ennis, N., Hobfoll, S., & Schroder, K. (2000). Money doesn’t talk, it swears: how economic stress and resistance resources impact inner-city women’s depressive mode. American Journal of Community Psychology, 28(2), 149–173.PubMedCrossRef

Goldman-Mellor, S., Saxton, K., & Catalano, R. (2010). Economic contraction and mental health: a review of the evidence, 1990–2009. International Journal of Mental Health, 39(2), 6–31.CrossRef

Himle, J., Baser, R., Taylor, R., Campbell, R., & Jackson, J. (2009). Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States. Journal of Anxiety Disorders, 23(5), 578–590.PubMedCrossRef

Hogan, M. (2003). The president’s new freedom commission: recommendations to transform mental health care in America. Psychiatric Services, 54, 1467–1474.PubMedCrossRef

Institute of Medicine of The National Academies. (2006). Hospital-based emergency care at the breaking point. Washington, DC: The National Academy Press.

Jaynes, G., & Williams, R. (1989). A common destiny: blacks and American society. Washington, DC: National Academies Press.

Liu, L., & Hudak, G. (1994). Forecasting and time series analysis using the SCA statistical system. Oak Brook: Scientific Computing Associates.

Lopez, M. H., & Cohn, D. V. (2011). Hispanic poverty rate highest in new supplemental census measure (pp. 6). Washington, DC: Pew Hispanic Center. Archived by WebCite^® at http://www.webcitation.org/63t69QjvK. Accessed 15 Nov 2012.

Handwerker, E. W., & Mason, L. G. (2012). Which layoffs—and which laid-off workers—are in the mass layoff statistics? Monthly Labor Review, 135(10), 17.

Montgomery, S., Cook, D., Bartley, M., & Wadsworth, M. (1999). Unemployment pre-dates symptoms of depression and anxiety resulting in medical consultation in young men. International Journal of Epidemiology, 28, 95–100.PubMedCrossRef

Neighbors, H., Caldwell, C., Williams, D., Nesse, R., Taylor, R., Bullard, K., et al. (2007). Race, ethnicity, and the use of services for mental disorders. Archives of General Psychiatry, 64(4), 485–494.PubMedCrossRef

Nobles, J., Brown, R., & Catalano, R. (2010). National independence, women’s political participation, and life expectancy in Norway. Social Science and Medicine, 70(9), 1350–1357.PubMedCentralPubMedCrossRef

Perreira, K. (2006). Crowd-in: the effect of private health insurance markets on the demand for Medicaid. Health Services Research, 41(5), 1762–1781.PubMedCentralPubMedCrossRef

Perron, R. (2010). African American experiences in the economy: recession effects more strongly felt. Washington, DC: AARP.

Rook, K., Dooley, D., & Catalano, R. (1991). Stress transmission: the effects of husbands’ job stressors on the emotional health of their wives. Journal of Marriage and Family, 5, 165–177.CrossRef

Schneider, S. M., Schafermeyer, R., & Zwemer, F. (2003). Emergency department crowding: a point in time. Annals of Emergency Medicine, 42, 167–172.PubMedCrossRef

Snowden, L., Catalano, R., & Shumway, M. (2009a). Disproportionate use of psychiatric emergency services by African Americans source. Psychiatric Services, 60(12), 1664–1671.PubMedCrossRef

Snowden, L., Masland, M., Fawley, K., & Wallace, N. (2009b). Ethnic differences in children’s entry into public mental health care via emergency mental health services. Journal of Child and Family Studies, 18, 512–519.PubMedCentralPubMedCrossRef

Snowden, L., Masland, M., Fawley, K., Wallace, N., & Cuellar, A. (2008a). Increasing California children’s Medicaid-financed mental health treatment by vigorously implementing Medicaid’s early periodic screening, diagnosis and treatment (EPSDT) program. Medical Care, 46(6), 558–564.PubMedCrossRef

Snowden, L., Masland, M., Libby, A., Wallace, N., & Fawley, K. (2008b). Racial/ethnic minority children’s use of psychiatric emergency care in California’s public health system. American Journal of Public Health, 98(1), 118–124.PubMedCentralPubMedCrossRef

The Kaiser Family Foundation. (2007). Key facts: Race, ethnicity & medical care. from http://www.kff.org/minorityhealth/6069.cfm. Accessed 5 Feb 2013.

The National Research Council. (2007). Emergency care for children: growing pains. Washington, DC: The National Academies Press.

Thompson, R., Dancy, B. L., Wiley, T. R., Najdowski, C. J., Perry, S. P., Wallis, J., et al. (2012). African American Families’ Expectations and Intentions for Mental Health Services. Administration and Policy in Mental Health and Mental Health Services Research.

Upshur, R., Knight, K., & Goel, V. (1999). Time-series analysis of the relation between influenza virus and hospital admissions of the elderly in Ontario, Canada, for pneumonia, chronic lung disease, and congestive heart failure. American Journal of Epidemiology, 149(1), 85–92.PubMedCrossRef

Verhulst, F., & Van der Ende, J. (1997). Factors associated with child mental health service use in the community. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 901–909.PubMedCrossRef

Williams, D., Gonzalez, H., Neighbors, H., Nesse, R., Abelson, J., Sweetman, J., et al. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites. Archives of General Psychiatry, 64, 305–315.PubMedCrossRef

Title: Racial/Ethnic Disparities in Children’s Emergency Mental Health After Economic Downturns
Authors: Tim Bruckner
Yonsu Kim
Lonnie Snowden
Publication date: 01-05-2014
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 3/2014
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-013-0474-8

At a glance: The STEP trials

Springer Medicine

Racial/Ethnic Disparities in Children’s Emergency Mental Health After Economic Downturns

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2014

Homelessness in a National Sample of Incarcerated Veterans in State and Federal Prisons

Measuring Perceived Rehabilitation Needs of Caregivers of People with Schizophrenia in Mainland China

Service Referral for Juvenile Justice Youths: Associations with Psychiatric Disorder and Recidivism

Erratum to: Trauma-Focused Treatment in a State System of Care: Is It Worth the Cost?

Trauma-Focused Treatment in a State System of Care: Is It Worth the Cost?

Generating Dialogical Practices in Mental Health: Experiences from Southern Norway, 1998–2008