Scope-of-Practice Expansions Associated with Reduced Racial Disparities in Pediatric Mental Health Care.

Area of Science:

• Health Services Research
• Health Disparities
• Pediatric Mental Health Policy

Background:

• Racial and ethnic disparities persist in pediatric mental health care access.
• Scope-of-practice (SoP) regulations for healthcare professionals may influence these disparities.
• Understanding the impact of SoP expansions on equitable care is crucial.

Purpose of the Study:

• To investigate the association between SoP regulations for psychologists and nurse practitioners (NPs) and racial disparities in pediatric mental health services.
• To determine if SoP expansions affect unmet mental health care needs and medication receipt differently across racial/ethnic groups.

Main Methods:

• Analysis of the National Survey of Children's Health (2016-2020; n=33,790).
• Comparison of outcomes in states with and without SoP expansions for psychologists and NPs.
• Logistic regression with interaction terms to examine heterogeneous treatment effects by race/ethnicity.

Main Results:

• Psychologist SoP expansion significantly reduced unmet mental health needs more for 'Other-race' children compared to White children.
• Psychologist SoP expansion increased mental health medication receipt more for Black and 'Other-race' children than White children.
• No significant impact on racial disparities was observed for nurse practitioner SoP expansion.

Conclusions:

• Expanded scope-of-practice for psychologists is associated with reduced racial disparities in pediatric mental health care access.
• Policy implications suggest that specific professional SoP expansions can mitigate inequities in child mental healthcare.
• Further research is needed to understand the varied effects of NP SoP expansions.