Demand analysis of mental health service use among ethnic subpopulations

This paper estimates demand for mental health services by blacks, Hispanics, and whites, as well as males and females, using a three-part regression model. It examines the probability of mental health use and the level of outpatient and inpatient use. The data base is the high option Blue Cross/Blue Shield Federal Employee Health Benefits Plan for the 1979 to 1981 period. All user subpopulations sharing this plan have the same coverage, so differences in demand and utilization are related to ethnic and racial background, age, salary, outpatient visit copayment and market area characteristics, including the supply of psychiatrists. Results show vast differences in demand for care by ethnic, racial, and gender groups with identical insurance coverage. Alternative explanations for the differences are suggested.