Objective: There has been an increase in youth psychiatric emergencies and psychiatric inpatient hospitalizations in recent years. Mobile crisis responses (MCR) services offer an opportunity to meet acute youth mental health needs in the community and provide linkage to care. However, an understanding of MCR encounters as a care pathway is needed, including how patterns of subsequent care may vary by youth race/ethnicity. The current study examines racial/ethnic differences in the rates of inpatient care utilization following MCRs among youth.

Method: Data included Los Angeles County Department of Mental Health (LACDMH) administrative claims for mobile crisis response (MCR) in 2017 and psychiatric inpatient hospitalizations and outpatient services from 2017-2020 for youth ages 0 to 18.

Results: In this sample of 6,908 youth (70.4% racial/ethnic minoritized youth) who received a MCR, 3.2% received inpatient care within 30 days of their MCR, 18.6% received inpatient care beyond 30 days of their MCR, and 14.7% received repeated inpatient care episodes during the study period. Multivariate models revealed that Asian American/Pacific Islander (AAPI) youth were less likely to receive inpatient care, whereas American Indian/Alaska Native (AI/AN) youth were more likely to receive inpatient care following MCR. Youth age, primary language, primary diagnosis, and insurance status also predicted future inpatient episodes.

Conclusion: Findings highlight differential rates of inpatient utilization following MCR among AAPI and AI/AN youth relative to youth from other groups. Alternative interpretations for the findings are offered related to differential levels of need and disparate penetration of community-based outpatient and prevention focused services.