Date of Award

Summer 1997

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program/Concentration

Urban Services--Health Services

Committee Director

Richardean Benjamin-Coleman

Committee Member

Clare Houseman

Committee Member

Jeffrey Levin

Committee Member

Lindsay Rettie

Abstract

Despite the efficacy of community-based treatment, many emotionally and behaviorally disturbed youth still receive restrictive service placements. This is quite problematic for minority youth since studies have reported they are more at risk of out-of-home placements. The purpose of this study was to examine differences in referrals, out-of-home placements, residential placements and length of service for African-American and Caucasian youth. This historical cohort study was a secondary analysis of data from the Comprehensive Services Act in Virginia. The sample consisted of 2,883 youth ages 10-19. Multiple logistic regression was employed for data with dichotomous outcomes in order to adjust for factors such as age, gender and presenting problem. Multiple linear regression was employed for interval outcome data in order to adjust for age, gender and presenting problems.

Ethnic differences were noted for type of referral, out-of-home placement, residential placements and length of service. African-Americans were more likely to have formal and social agency referrals to CSA than Caucasian youth. The effect of ethnicity on school referrals was found to depend on whether the youth had abuse, cognitive or emotional problems. Among youth without these problems, African-Americans were less likely to have school referrals. Among youth with these problems, African-Americans were over 2 times more likely to have referrals from schools. Furthermore, African-Americans were 1.32 times more likely to have out-of-home placements prior to CSA enrollment than Caucasians. The effect of ethnicity on residential placements was found to depend on whether the youth was delinquent. Among youth who were delinquent, African-Americans were.755 times less likely to have residential placements while receiving services through CSA. African-Americans were also found to have a significantly shorter (295.7) length of service in CSA than Caucasians (353.6).

This study indicates some of the factors associated with referrals, out-of-home placements, residential placements and length of service for youth with serious emotional and behavioral problems in the child mental health system. Ethnicity was found to be a significant factor associated with type of referrals, placements and length of service. Policy makers and service providers should be apprised of the fact that African-American youth may have different paths to treatment and these differences may affect the type of placement, and length of service for these youth. More information is needed that will document how these factors may affect treatment outcomes for African-American youth.

DOI

10.25777/cjmt-nv49

ISBN

9780591603965

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