Racial-ethnic differences in service use patterns among young, commercially insured individuals with recent-onset psychosis

Objective: The aim of this study was to investigate racial-ethnic differences in use of mental health services and antipsychotic medication in the year following the recent onset of a psychotic disorder and to examine the role of household income as a proxy for socioeconomic status. Methods: Deidentified administrative claims data from the OptumLabs Data Warehouse were used to identify 8,021 commercially insured individuals ages 14 through 30 with a recent-onset psychotic disorder (January 1, 2011, through December 31, 2015). The authors compared mental health service use among African-American (11.5%), Hispanic (11.0%), and non-Hispanic white (77.4%) individuals during the year following an index diagnosis and adjusted these analyses for household income. Results: The probability of any use of outpatient mental health services was lower among African-American (67.4%6 1.4%) and Hispanic individuals (66.5%61.5%) compared with non-Hispanic white patients (72.3%60.6%; p,0.05 for each comparison). Among those who used services, African-American and Hispanic individuals had fewer mean outpatient mental health visits per year compared with non-Hispanic whites (9.760.7 and 10.260.7 versus 14.360.5, respectively, p,0.001 for each comparison). These racial-ethnic differences in service use remained after adjustment for household income. Conclusions: Among young, commercially insured individuals using outpatient services following an index diagnosis of psychotic disorder, African Americans and Hispanics received less intensive outpatient mental health care than their non-Hispanic white counterparts. Amid the upsurge of early intervention programs, special attention should be paid to increasing access to mental health services for racial-ethnic minority groups.