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APHA Scientific Session and Event Listing

Nadine Barrett, PhD, Cecil G. Sheps for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB#7590, Chapel Hill, NC 27599-7590, 919-966-5829, nbarrett@schsr.unc.edu

Purpose: Current research suggests disparities exist for minority populations in access and use of community-based mental health services. Do these disparities carry-over to mentally ill detainees in jail? This study examines the extent to which racial differences exist with regard to jail mental health service use among detainees.

Methods: This presentation addresses these issues with data over a five-year (1993-98) time period from King County (Seattle), WA. A quasi-experimental design was used to compare the jail behavioral health experiences – utilization and costs – among 4,888 white and black jail detainees with severe mental illness.

Results: Among jail detainees with severe mental illness, 67% of white detainees received behavioral health care during their incarceration compared to only 37% of black detainees. Among those who received care, however, more was spent on black detainees (M = $11,243, SD = $21,411, Mdn = $2,096) compared to their white counterparts (M = $ 6,977, SD = $14,006, Mdn = $1,452, p < .001).

Conclusions: These findings suggest that black jail detainees with severe mental illness are less likely to receive behavioral health care , but more is spent on their care when they do receive it compared to white detainees. Jails are a public health outpost and developing effective interventions for detainees that are fair and equitable may increase continuity of care with community services and reduce future detentions.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to discuss the extent to which racial differences exist with regard to jail mental health service use among detainees.

Keywords: Mental Health Services, Mental Illness

Presenting author's disclosure statement:

Any relevant financial relationships? No