Objective:
Black youth face numerous barriers to equitable mental health care that contribute to service underutilization. Some clinicians and researchers encourage matching Black youth with Black clinicians as a strategy to mitigate the effects of these barriers and improve treatment outcomes and engagement. Evidence in the adult therapy literature demonstrates that racial matching can improve treatment outcomes (i.e., symptom reduction) for Black adults; however, youth research is limited and largely restricted to traditional outpatient treatment models. Pediatric integrated primary care (IPC) aims to improve mental health access by embedding mental health services into primary care clinics; however, little is known about how racial match influences service utilization and delivery in pediatric IPC for Black youth.
Method:
We utilized retrospective chart review to examine associations between patient–psychology clinician racial match and service utilization and delivery in a pediatric IPC clinic serving predominately Black families (N = 234, 50% female, 100% Black). Our primary measures of interest were patient–provider racial match, psychology attendance rate, and first encounter diagnosis.
Results:
Black clinicians were grossly underrepresented in our dataset and families had limited opportunities to receive racially matched care. Black youth attendance rates were unrelated to working with a Black clinician, but youth were more likely to receive a developmental/learning/autism diagnosis during their first encounter when working with a Black clinician.
Conclusions:
Racially matched care in IPC remains a promising strategy to improve care and warrants further investigation, both in the literature and in clinical practice.
Implications for Impact Statement
Pediatric integrated primary care aims to improve mental health access by embedding mental health services into primary care clinics; however, no research explores if racial match between Black mental health clinicians and Black youth influences care in this setting. Although Black clinicians were underrepresented in our clinic and families had limited opportunities to receive racially matched care, Black youth were more likely to receive a diagnosis related to development, learning, or autism when working with a Black clinician. Racially matched care in integrated primary care remains a promising strategy to address mental health inequity for Black youth and warrants further investigation.
