Youth in Emergency: how and why youth of color use psychological stabilization services.

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Abstract Racial disparities in mental health treatment remain persistent, particularly among youth (ages 12-21). Youth of color (YOC) are accessing psychological stabilization services through emergency departments and mobile crisis teams (ED/MCTs) at increasing rates, but there is little information as to why. I propose a qualitative investigation of how YOC prior experiences seeking mental health care have influenced their use of emergency psychiatric services. The proposed case study will be guided by the Candidacy model, a framework that has been successfully used to unpack patients’ experiences with the health care system, elucidate patients’ pathways to appropriate and timely care, and characterize how patients are misdirected. To generate new evidence as to why youth of color are using EDs for mental health care, I will explore the mental health Candidacy experiences of youth of color who received emergency psychological triage in 2021 from the Boston Emergency Services Team (BEST) an initiative spanning five cities in Massachusetts that include psychiatric emergency room visits, crisis care services, and/or mobile crisis unit interventions. My aims include 1. To determine how and why YOC became candidates for emergency psychological stabilization services; 2. To characterize the youth’s prior mental health care experiences and explore how racism and parent involvement influenced those experiences; and 3. To explore how their candidacy with BEST was similar or dissimilar from prior mental health care experiences. I will perform qualitative thematic analysis of key informant interviews and non-participant observation of post-stabilization follow-up visits. Participants will include up to 30 YOC, their parents/guardians, and BEST clinicians. From this 12-month study, I will generate transferable findings that inform the ongoing efforts to provide youth of color with access to needed and appropriate mental health care and contribute to the literature on Candidacy. From this project I will produce two publications in peer-reviewed journals (one on patient experiences with MCT/ED, and the other on the role of candidacy in ED/MCT use). I will present study findings at conferences and to BEST stakeholders to provide wider learning to the professional community of mental health care providers and program managers.