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The Potential to Reduce Mental Health Disparities Through the Comprehensive Community Mental Health Services for Children and Their Families Program

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Abstract

Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race–ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997 to 2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all Children’s Mental Health Initiative communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized.

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Acknowledgement

This research was supported by National Institute of Mental Health Grant # 1R01MH075828 and carried out at the Johns Hopkins Bloomberg School of Public Health. The views expressed are the opinions of the authors and not those of the National Institute of Mental Health, the National Institute of Health, or the federal government.

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Authors and Affiliations

  1. Department of Health and Behavioral Sciences, University of Colorado at Denver and Health Sciences Center, Campus Box 188, P.O. Box 173364, Denver, CO, 80217-3364, USA

    Richard Miech PhD

  2. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 8th Floor, 624 N. Broadway, Rm 839, Baltimore, MD, 21205, USA

    Melissa Azur PhD, Tracy Dusablon MHS, Keri Jowers M.Ed., Elizabeth A. Stuart AM, PhD & Philip J. Leaf PhD

  3. Child and Adolescent Preventive Intervention Program, National Institute of Mental Health, 6001 Executive Boulevard, Room 7144, MSC 9631, Rockville, MD, 20892-9631, USA

    Amy B. Goldstein PhD

  4. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, 8th Floor, Baltimore, MD, 21205, USA

    Elizabeth A. Stuart AM, PhD

  5. Macro International Inc., 166 John Street, Suite 800, New York, NY, 10038, USA

    Christine Walrath PhD, MHS

  6. Department of Psychiatry, Johns Hopkins School of Medicine, 624 N Broadway, 8th Floor, Baltimore, MD, 21205, USA

    Philip J. Leaf PhD

  7. Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    Christine Walrath PhD, MHS

  8. University of Maryland Baltimore County, Catonsville, MD, USA

    Christine Walrath PhD, MHS

Authors
  1. Richard Miech PhD
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  2. Melissa Azur PhD
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  3. Tracy Dusablon MHS
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  4. Keri Jowers M.Ed.
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  5. Amy B. Goldstein PhD
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  6. Elizabeth A. Stuart AM, PhD
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  7. Christine Walrath PhD, MHS
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  8. Philip J. Leaf PhD
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Corresponding author

Correspondence to Richard Miech PhD.

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Miech, R., Azur, M., Dusablon, T. et al. The Potential to Reduce Mental Health Disparities Through the Comprehensive Community Mental Health Services for Children and Their Families Program. J Behav Health Serv Res 35, 253–264 (2008). https://doi.org/10.1007/s11414-008-9123-5

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  • DOI: https://doi.org/10.1007/s11414-008-9123-5

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