The effect of income and race on quality of psychiatric care in community mental health centers.

This study examined the relationship between quality of mental health care provided by community mental health centers (CMHCs) and the poverty and racial mix of neighborhoods. Indicators of quality of care were constructed by examining service mix and prescription patterns for adult patients with schizophrenia during fiscal year 1996. CMHCs in high income, Caucasian areas were found to have higher quality of care indicators than those in low income, African American areas; i.e., higher percentage of patients on atypical antpsychotic prescriptions (47% vs. 33%) and higher percentage using intensive case management (ICM) services (67% vs. 29%). Questions arise regarding the factors underlying this phenomena and the extent to which they are provider-driven or due to patient preferences.