Racial Disparities in Access to and Utilization of Jail- and Community-Based Mental Health Treatment in 8 US Midwestern Jails in 2017

• Published in: American journal of public health (1971) Vol. 111; no. 2; pp. 277 - 285
• Main Authors: Hedden, Bethany Joy, Comartin, Erin, Hambrick, Nanci, Kubiak, Sheryl
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01-02-2021
• Subjects: Access to Care; Adult; Female; Health Service Delivery; Health Services Accessibility - statistics & numerical data; Humans; Jails; Male; Medicaid; Mental Disorders - therapy; Mental Health; Mental Health Services - statistics & numerical data; Middle Aged; Midwestern United States; Patient Acceptance of Health Care - statistics & numerical data; Prisoners - statistics & numerical data; Race/Ethnicity; Racism - statistics & numerical data; Research and Analysis; Substance Use; Substance-Related Disorders - therapy; United States; Young Adult; Midwestern United States; United States
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2020.305992

To examine the dual disproportionality that individuals with serious mental illness and people of color (PoC) occupy in the criminal-legal system.
This study follows a cohort of 623 individuals who screened positive for mental health issues at booking in 8 Midwestern jails in 2017. We followed individuals through the jails' practices of jail-based mental health treatment, and we used Medicaid billing data to assess community-based behavioral health treatment engagement in the postyear period after jail release. The aim was to examine if an individual's race/ethnicity was associated with their access to jail- and community-based mental health treatment.
We did not find any racial disparities in jail-based treatment, although 3 community-based outcomes significantly differed. Compared with PoC, White people had 1.9 times greater odds of receiving community-based mental health and substance use treatment and 4.5 times greater odds of receiving co-occurring disorder treatment.
Barriers that individuals released from jail face adversely affect PoC, resulting in reduced access to treatment. Critical race theory can expose the assumptions and functions of systems of care and the possible reproduction of implicit bias in potential solutions.