Is Science Reaching Minority Youth in Residential Care? Findings of Empirically Supported Treatments and Outcomes Across Race

Background: Childhood mental health problems represent a significant public health concern globally. Despite wide spread empirically supported treatment use throughout services there is a converging discussion among researchers and practitioners alike that the research results of effectiveness studies are not fully generalizable and applicable to ethno-racial minority groups in real-world practice settings. With empirically supported treatments being derived from majority sample frames, what remains relatively unknown is whether science is reaching minority youths. The objective of this study is to investigate differences of outcomes between majority and minority youths who received mental health treatment in a residential facility that provides empirically supported treatments. It is hypothesized that empirically supported treatments are not reaching minority youth resulting in poorer outcomes.   

Methods: Archival data on discharges between July 1, 2009 and December 31, 2010 (n=161) from eight residential programs for children and youth aged 5 to 18 and operated by a large, US-based (New York State) child and family human services agency were analyzed to identify the relationship of client demographics (gender, minority ethnic status, and age group) to treatment success and disengagement from treatment.

Results: Minority ethnic status was associated with lower odds of treatment success (OR = 0.21, 95% CI [0.10–0.46]) and higher odds of disengagement from treatment (OR = 12.1, 95% CI [2.67–54.5]). Younger age (less than 13 years) also was associated with success (OR = 0.27, 95% CI [0.08–0.93]).

Discussion and Implications: The results, although only for a single large agency, found that minority children and youth in residential programs had less favorable outcomes, in terms of both disengagement from treatment and a successful discharge, than white children and youth. Given the fact that these residential facilities used empirically supported treatments, calls into question whether these treatments best serve ethno-racial minority groups in real-world practice settings. Until empirically proven otherwise, empirically supported treatments that have not been validated with any assistance from minority populations should come with a very clear warning label indicating this significant limitation.