Inpatient Care Utilization Following Mobile Crisis Response Encounters Among Racial/Ethnic Minoritized Youth

Joyce H L Lui; Belinda C Chen; Lisa A Benson; Yen-Jui R Lin; Amanda Ruiz; Anna S Lau

doi:10.1016/j.jaac.2023.06.021

Inpatient Care Utilization Following Mobile Crisis Response Encounters Among Racial/Ethnic Minoritized Youth

J Am Acad Child Adolesc Psychiatry. 2023 Jul 6:S0890-8567(23)00381-7. doi: 10.1016/j.jaac.2023.06.021. Online ahead of print.

Authors

Joyce H L Lui¹, Belinda C Chen², Lisa A Benson³, Yen-Jui R Lin³, Amanda Ruiz³, Anna S Lau²

Affiliations

¹ Concordia University, Montréal, Québec. Electronic address: joyce.lui@concordia.ca.
² University of California, Los Angeles, Los Angeles, California.
³ Los Angeles County Department of Mental Health, Los Angeles, California.

PMID: 37422107
DOI: 10.1016/j.jaac.2023.06.021

Abstract

Objective: There has been an increase in youth psychiatric emergencies and psychiatric inpatient hospitalizations in recent years. Mobile crisis response (MCR) services offer an opportunity to meet acute youth mental health needs in the community and to provide linkage to care. However, an understanding of MCR encounters as a care pathway is needed, including how patterns of subsequent care may vary by youth race/ethnicity. The current study examines racial/ethnic differences in the rates of inpatient care use following MCR among youth.

Method: Data included Los Angeles County Department of Mental Health (LACDMH) administrative claims for MCR in 2017 and psychiatric inpatient hospitalizations and outpatient services from 2017-2020 for youth aged 0 to 18 years.

Results: In this sample of 6,908 youth (70.4% racial/ethnic minoritized youth) who received an MCR, 3.2% received inpatient care within 30 days of their MCR, 18.6% received inpatient care beyond 30 days of their MCR, and 14.7% received repeated inpatient care episodes during the study period. Multivariate models revealed that Asian American/Pacific Islander (AAPI) youth were less likely to receive inpatient care, whereas American Indian/Alaska Native (AI/AN) youth were more likely to receive inpatient care following MCR. Youth age, primary language, primary diagnosis, and insurance status also predicted future inpatient episodes.

Conclusion: Findings highlight differential rates of inpatient use following MCR among AAPI and AI/AN youth relative to youth from other groups. Alternative interpretations for the findings are offered related to differential levels of need and disparate penetration of community-based outpatient and prevention-focused services.

Keywords: inpatient hospitalizations; mobile crisis response; racial/ethnic disparities; tertiary care.