Race, psychiatric diagnosis, and mental health care utilization in older patients

To evaluate the impact of race on mental health care utilization among olde r patients within given clinical psychiatric diagnoses, the authors examine d a retrospective sample of 23,718 elderly veterans treated in Department o f Veterans Affairs inpatient facilities in 1994. Significant racial differe nces in mental health care utilization found over a subsequent 2-year perio d were related to outpatient (but not inpatient) care; for instance: 1) Afr ican American patients with psychotic disorders had significantly fewer out patient psychiatric visits; and 2) African American patients with substance abuse disorders had significantly more psychiatric visits than Caucasian p atients in their respective groups. Although inpatient utilization appeared to be similar among races, findings related to outpatient utilization may be associated with such factors as compliance, treatment efficacy access to health care, or possible clinician bias.