The Asian American population comprises historically, socially, and culturally diverse ethnic groups. Given this diversity, investigators caution that combining disparate ethnic groups together may lead to erroneous conclusions. Whether by choice or necessity, however, mental health studies still typically consider Asian Americans as a single ethnic category rather than as separate ethnic groups. Few investigations have addressed the consequences of this practice. This paper examines the implications of conceptualizing Asian Americans as an ethnic category versus ethnic groups, in an investigation of the community functioning status of clients in publicly funded mental health programs in King County, Washington. When treated as a single ethnic category in a multivariate linear regression model, Asian Americans are found to have a lower level of functioning difficulty than their white counterparts. However, when treated as separate ethnic groups (e.g., Vietnamese, Japanese), only one of five Asian ethnic groups has a significantly lower level of difficulty. In a separate analysis of the Asian American subsample, groups are found to differ significantly from one another with respect to functional status. Several factors, including refugee status, account for this difference.
Preliminary empirical evidence indicates that the level-of-care decision-support tool is reliable and valid. It could be further refined by incorporating the impact of social supports, collateral services, current mental health services, and motivation for services.
A team of service system planners in King County, Washington, field-tested the feasibility of the LONCA (level of need-care assessment) method as a strategy to match resources to consumer level of need. LONCA links resources to need by first measuring the incidence and intensity of consumer needs in specific functioning domains. It then preliminarily specifies the type and intensity of services required to minimally but appropriately address specific consumer needs, calculates service costs, and identifies clusters of consumers with similar need and cost profiles. The field test supported the feasibility of performing LONCA tasks. The resulting scheme for clustering consumers appeared to have face validity and was modestly associated with at least 3 independent indicators of resource need: program status, residential status, and hospitalizations. Despite its limitations, the article supports further development of LONCA for use as a resource allocation tool for local service systems.
The PSS is a brief, easily administered instrument that shows psychometric promise for use in clinical contexts, such as treatment planning, concurrent review of care, and guidance for level-of-care decisions, as well as for quality management purposes.
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