Racial and Ethnic Disparities in Community Mental Health Use Among Autistic Adolescents and Young Adults

Teal W. Benevides, Jennifer E. Jaremski, Ed Dee Williams, Wei Song, Hoangmai H. Pham, Lindsay Shea

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The purpose of this cohort study was to evaluate differences in rate of co-occurring mental health (MH) conditions among transition-age autistic youth (TAYA) who are Black, indigenous, and other people of color, and to identify enabling variables associated with any community MH visit in this population. Methods: Medicare-Medicaid Linked Enrollees Analytic Data Source 2012 data were used for this study. TAYA 14–29 years old who received fee-for-service Medicare, Medicaid, or both were included. Predisposing, enabling, and need variables associated with both presence of MH conditions and any community MH visit were examined with general linear modeling. Results: N = 122,250 TAYA were included. Black, Asian/Pacific Islander, and Hispanic TAYA were significantly less likely than White TAYA to have a diagnosis of substance-use, depressive, anxiety, attention-deficit hyperactivity disorder, or post-traumatic stress disorders. These groups were also significantly less likely to have had a community MH visit in the past year after controlling for predisposing, enabling, and need variables. Enabling variables associated with greater use of at least one community MH visit included dual enrollment in both Medicare and Medicaid and 12+ months of enrollment in 1115 or 1915(C) Medicaid waivers. Discussion: Service delivery factors are an important area of future research, particularly dual enrollment and coverage disparities for Black, indigenous, and other people of color TAYA. Examining coverage of managed care enrollees, including differences by state, may offer additional insights on how these factors impact care.

Original languageEnglish (US)
Pages (from-to)1208-1216
Number of pages9
JournalJournal of Adolescent Health
Volume74
Issue number6
DOIs
StatePublished - Jun 2024

Keywords

  • Adolescents
  • Autism
  • Community services
  • Health service access
  • Medicaid
  • Medicare
  • Mental health
  • Racial disparities
  • Transition-age youth
  • Young adults

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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