Using decision support to address racial disparities in mental health service utilization

Unfortunately, racial disparities are well documented in the delivery of behavioral health services. This study examines the effects of implementing a decision support process, integrating clinical information into the administration of mental health services, on racial disparities in psychiatric hospital admissions for children in state custody. Differences in a hospitalization prediction model and the proportion of low-risk admissions in Caucasian, African American, and Hispanic youth from 1998 to 2002 were assessed in a statewide sample of 7, 653 screenings. Differences in low-risk admissions were assessed after the 1999 initiation of the decision support process. Following the initiation of feedback to clinicians and the use of the Childhood Severity of Psychiatric Illness (CSPI), a decision support tool, the hospitalization prediction model improved significantly. The proportions of low-risk Caucasian and Hispanic youth hospitalized decreased from 1998 to 1999; the proportions of low-risk African American youth hospitalized during this period significantly decreased. In addition to traditional methods of addressing racial disparities in behavioral health care, such as increasing cultural competence in service delivery, providing feedback to service providers to improve the consistency of decision-making may have significant secondary impacts on other system problems-in this case, racial disparity.