Medicaid, Race, Utilization of Crisis Services at Community Mental Health Agencies

We compare African-American and White clients receiving services at 13 rural and semi-rural community mental health agencies (CMHAs) and the impact of Medicaid on the use of crisis and outpatient services. SEM was utilized to model the indirect effect of crisis services between the association of Medicaid and total hours of outpatient services. We modeled the moderating effects of race using mixture modeling and latent class. The base model showed a non-significant indirect effect between having Medicaid and total hours of services through the use of crisis services (Indirect effect = 0.01, p = .98). African-American clients who received Medicaid were more likely to use crisis services (β= .155, p < .05, a path), which was associated with increased hours of outpatient services (β= .224, p < .05, b path). In general, Medicaid was not related to increase service or crisis service usage. However, African-American clients access crisis services significantly more than White clients.