Racial and Ethnic Variations in a Multi-Channel Psychiatric Emergency Services Program

Area of Science:

• Mental Health Services Research
• Health Disparities
• Psychiatric Emergency Care

Background:

• Adult mental health emergency department visits have risen significantly over the last 20 years.
• Existing research shows a gap in understanding racial and ethnic disparities within psychiatric emergency services (PES).

Purpose of the Study:

• To investigate racial and ethnic differences in evaluation location, diagnosis, and discharge disposition among adults accessing multi-channel psychiatric emergency services.
• To identify potential disparities in the care pathway for diverse patient populations.

Main Methods:

• Analysis of 61,663 psychiatric emergency service encounters for adults aged 22 and over between 2017 and 2021.
• Comparison of evaluation settings, diagnoses, and discharge outcomes across racial and ethnic groups, including non-Latino White, non-Latino Black, and Latino clients.
• Statistical analysis using odds ratios (OR) to determine significant differences.

Main Results:

• Individuals of color comprised nearly 50% of adult PES encounters.
• Non-Latino Black and Latino clients were more likely to be evaluated in psychiatric urgent care clinics (UCCs) and private homes compared to non-Latino White clients.
• Clients of color had higher odds of receiving a primary psychotic disorder diagnosis and lower odds of admission to 24-hour care.

Conclusions:

• Racial and ethnic minority groups are more frequently evaluated in non-emergency department settings when alternative options are available.
• Significant racial and ethnic variations in emergency mental health service processes and outcomes necessitate further investigation into underlying causes.
• Findings highlight the need to address systemic factors contributing to disparities in mental health crisis care.