TY - JOUR
T1 - Growing inequities in mental health crisis services offered to indigent patients in Puerto Rico versus the US states before and after Hurricanes Maria and Irma
AU - Purtle, Jonathan
AU - Rivera-González, Alexandra C.
AU - Mercado, Damaris Lopez
AU - Barajas, Clara B.
AU - Chavez, Ligia
AU - Canino, Glorisa
AU - Ortega, Alexander N.
N1 - Funding Information:
This study was supported by grants R01MD016426 and R01MD013866 from the National Institute on Minority Health and Health Disparities (NIMHD) at the National Institutes of Health (NIH).
Publisher Copyright:
© 2022 Health Research and Educational Trust.
PY - 2023/4
Y1 - 2023/4
N2 - Objective: To assess changes in the availability of mental health crisis services in Puerto Rico relative to US states before and after Hurricanes Maria and Irma. Data Sources/Study Setting: National Mental Health Services Surveys conducted in 2016 and 2020. Study design: Repeated cross-sectional design. The independent variable was mental health facility location in Puerto Rico or a US state. Dependent variables were the availability of three mental health crisis services (psychiatric emergency walk-in services, suicide prevention services, and crisis intervention team services). Data Collection/Extraction Methods: The proportion and per 100,000 population rate of facilities offering crisis services were calculated. Principal Findings: The availability of crisis services at mental health facilities in Puerto Rico remained stable between 2016 and 2020. These services were offered less at indigent care facilities in Puerto Rico than US states (e.g., 38.2% vs. 49.5% for suicide prevention, p = 0.06) and the magnitude of difference increased following Hurricane Maria. Conclusions: There are disparities between Puerto Rico and US states in the availability of mental health crisis services for indigent patients.
AB - Objective: To assess changes in the availability of mental health crisis services in Puerto Rico relative to US states before and after Hurricanes Maria and Irma. Data Sources/Study Setting: National Mental Health Services Surveys conducted in 2016 and 2020. Study design: Repeated cross-sectional design. The independent variable was mental health facility location in Puerto Rico or a US state. Dependent variables were the availability of three mental health crisis services (psychiatric emergency walk-in services, suicide prevention services, and crisis intervention team services). Data Collection/Extraction Methods: The proportion and per 100,000 population rate of facilities offering crisis services were calculated. Principal Findings: The availability of crisis services at mental health facilities in Puerto Rico remained stable between 2016 and 2020. These services were offered less at indigent care facilities in Puerto Rico than US states (e.g., 38.2% vs. 49.5% for suicide prevention, p = 0.06) and the magnitude of difference increased following Hurricane Maria. Conclusions: There are disparities between Puerto Rico and US states in the availability of mental health crisis services for indigent patients.
KW - health care disparities
KW - health care organizations and systems
KW - indigent care
KW - mental health
KW - psychiatry
KW - uninsured/safety net providers
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U2 - 10.1111/1475-6773.14092
DO - 10.1111/1475-6773.14092
M3 - Article
C2 - 36310433
AN - SCOPUS:85141623116
SN - 0017-9124
VL - 58
SP - 325
EP - 331
JO - Health Services Research
JF - Health Services Research
IS - 2
ER -