Race in the Treatment of Homeless Mentally Ill Veterans

Leda, Catherine; Rosenheck, Robert A.

doi:10.1097/00005053-199508000-00006

Cited by 32 publications

(14 citation statements)

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“…Although the results did not support the study's hypotheses, they are consistent with other research findings that indicate that demographic characteristics do not predict treatment outcomes (7,8,18). Furthermore, that the pre-incarceration socioenvironmental characteristics were not predictive of postrelease drug use indirectly lends support to the research that highlights the importance of the current, rather than historical, social environment in efforts to maintain sobriety (19,(21)(22)(23)(24).…”

Section: Discussioncontrasting

confidence: 46%

“…Despite the diverse pre-treatment profiles among African American and white substance abuse treatment participants, a few recent treatment outcome studies have found that both African American and white clients benefit similarly from community-based treatment. (7,8,18). For example, in their evaluation of two separate samples of Vietnam veterans, Leda and Rosenheck (18) and Rosenheck and Seibyl (7) found that both African American and white homeless Vietnam veterans in each sample improved similarly on most behavioral indices (e.g., decreased drug use, increased employment) following treatment (one year and three months, respectively), despite the myriad differences between them at treatment entry.…”

Section: Comparison Of African American and White Substance Abusersmentioning

confidence: 99%

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Correlates of Drug Treatment Outcomes for African American and White Male Federal Prisoners: Results from the TRIAD Study

Rounds-Bryant¹,

Motivans

Pelissier

2004

The American Journal of Drug and Alcohol Abuse

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The purpose of this study was to compare the effects of family background and preincarceration socioenvironmental variables on three-year post-release drug use for African American and white prison-based drug treatment participants in order to explain the previously found disparities in rates of three-year post-release drug use between the two groups. There were two hypotheses: 1) for both groups, family background and preincarceration socioenvironmental variables would predict postrelease drug use more strongly than sociodemographic characteristics and preincarceration behaviors, and 2) the predictors would be different for each group. The sample included 279 African American and 512 white male treatment participants who were supervised by a U.S. probation officer following incarceration. Event history analyses were used to model time to first drug use during postrelease supervision. The results indicated that none of the family background factors or socioenvironmental variables predicted postrelease drug use. The variables predictive of drug use for one or both racial groups were limited to sociodemographic characteristics and preincarceration behaviors such as age at release, prior commitments, and preincarceration employment. Yet, there were no significant between-group differences for these predictors. The authors concluded that future assessment of the effects of socioenvironmental variables on postrelease drug use likely requires evaluation of the postrelease social environment at the time of release.

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Section: Discussioncontrasting

confidence: 46%

Section: Comparison Of African American and White Substance Abusersmentioning

confidence: 99%

Correlates of Drug Treatment Outcomes for African American and White Male Federal Prisoners: Results from the TRIAD Study

Rounds-Bryant¹,

Motivans

Pelissier

2004

The American Journal of Drug and Alcohol Abuse

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“…Our finding of a disparity in intensity of utilization of psychiatric outpatient services for blacks is not consistent with available evidence. A study of a homeless population of veterans with severe mental illnesses, a substance abuse problem, or both and who were receiving care from the Veterans Health Administration (VHA) found that blacks and whites had comparable service utilization (28). Further, a cost-effectiveness study based on data from a randomized trial of assertive community treatment versus usual care for home-less people with severe mental illnesses found that blacks and whites in the usual care arm of the trial had comparable utilization of outpatient mental health services (29,30).…”

Section: Discussionmentioning

confidence: 99%

Investigation of Racial and Ethnic Disparities in Service Utilization Among Homeless Adults With Severe Mental Illnesses

Horvitz-Lennon

Frank²,

Thompson³

et al. 2009

Psychiatric Services

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Objective To determine if service disparities exist among severely mentally ill homeless adults, a vulnerable population with a high level of unmet need. Methods This study used data collected at baseline for 6,829 black, Latino, and non-Latino white participants in the Access to Community Care and Effective Services and Support study. Outcome variables were measures of utilization of psychiatric outpatient, housing, and case management services in the previous 60 days. The sample was divided into white/black and white/Latino cohorts. Within each cohort, participants were stratified into comparable groups using propensity scores that estimated log-odds of being black or Latino as a function of several confounding variables. White minus black/Latino differences in mean number of visits (a measure of intensity) and in the mean probability of at least 1 visit (a measure of access) were subsequently estimated. Results The study sample consisted of 50% black, 6% Latino, and 44% white participants. Service utilization was low for the three services regardless of race/ethnicity. On multivariate analyses of service utilization in the previous 60 days, blacks had fewer psychiatric outpatient visits than whites (mean difference [95% CI] = 0.46 [0.10, 0.81]) yet Latinos had more case management visits than whites (mean difference [95% CI] = −0.51 [−1.03, −0.05]). Access analyses did not reveal disparities. Conclusions While blacks have lower intensity of psychiatric outpatient utilization than whites hence experiencing a service disparity, Latinos have higher intensity of case management utilization than whites. Possible contributors and clinical and methodological implications of these results are discussed.

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“…A study of homeless mentally ill and/or substance-abusing veterans receiving Veterans Health Affairs (VHA) care found that blacks and whites had comparable service utilization (29). Further, a cost-effectiveness study based on data from a randomized trial of assertive community treatment versus usual care for homeless people with severe mental illnesses found that blacks and whites in the usual care arm had comparable utilization of outpatient mental health services (30,31).…”

Section: Discussionmentioning

confidence: 99%

Investigation of Racial and Ethnic Disparities in Service Utilization Among Homeless Adults With Severe Mental Illnesses

Horvitz-Lennon¹,

Frank²,

Thompson³

et al. 2009

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Race in the Treatment of Homeless Mentally Ill Veterans

Cited by 32 publications

References 0 publications

Correlates of Drug Treatment Outcomes for African American and White Male Federal Prisoners: Results from the TRIAD Study

Correlates of Drug Treatment Outcomes for African American and White Male Federal Prisoners: Results from the TRIAD Study

Investigation of Racial and Ethnic Disparities in Service Utilization Among Homeless Adults With Severe Mental Illnesses

Investigation of Racial and Ethnic Disparities in Service Utilization Among Homeless Adults With Severe Mental Illnesses

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