Racial and Ethnic Disparities in Access to Mental Health Services for African and Arab American Youth: An Audit Study

Racial disparities exist in the quality of and access to mental health services for people of color. Provider bias has been found to avert African American adults from accessing services. However, it is unknown whether provider bias affects service access for African and Arab American youth. Moreover, little is known about the role of client gender and community variables such as urbanicity (i.e., urban versus non-urban) in access to care for youth. Audit methodology examined whether client race/ethnicity and gender predicted providers’ responses to help-seeking messages in an urban and non-urban area of Michigan. Voice actresses created audio recordings portraying a White, African American, or Arab American mother requesting a therapy appointment for her adolescent. Recordings were left on providers’ voicemails in Metro Detroit and Southwest Michigan. Data were collected on whether the providers: (i) called back, and (ii) initiated or denied services. The effect of client characteristics on the odds of a provider calling back differed by location. In the non-urban location, White clients had a 3.4–3.8 times greater odds of receiving a callback than the African and Arab American clients. Additionally, in the urban location, female clients had a 2 times greater odds of receiving a callback than the male clients. Findings from this study suggest that provider bias limited access to mental health services for African and Arab American adolescents in the non-urban location, highlighting the need for strategies to address disparities in access to mental health services for youth of color.