{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T15:10:10Z","timestamp":1750777810013,"version":"3.41.0"},"reference-count":54,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"unspecified","delay-in-days":174,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S003329172510069X_sec1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Low-income, publicly insured youth face numerous barriers to adequate mental health care, which may be compounded for those with multiple marginalized identities. However, no research has examined how identity and diagnosis may interact to shape the treatment experiences of under-resourced youth with psychiatric conditions. Applying an intersectional lens to treatment disparities is essential for developing targeted interventions to promote equitable care.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S003329172510069X_sec2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>Analyses included youth ages 7\u201318 with eating disorders (EDs; <jats:italic>n<\/jats:italic>\u00a0=\u00a03,311), mood\/anxiety disorders (<jats:italic>n<\/jats:italic>\u00a0=\u00a03,219), or psychotic disorders (<jats:italic>n<\/jats:italic>\u00a0=\u00a03,035) enrolled in California Medicaid. Using state billing records, we examined sex- and race and ethnicity-based disparities in receipt of core services \u2013 outpatient therapy, outpatient medical care, and inpatient treatment \u2013 in the first year after diagnosis and potential differences across diagnostic groups.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S003329172510069X_sec3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Many youth (50.7% across diagnoses) received no outpatient therapy, and youth with EDs were least likely to receive these services. Youth of color received fewer days of outpatient therapy than White youth, and Latinx youth received fewer therapy and medical services across outpatient and inpatient contexts. Sex- and race and ethnicity-based disparities were especially pronounced for youth with EDs, with particularly low levels of service receipt among boys and Latinx youth with EDs.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S003329172510069X_sec4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Results raise concerns for unmet treatment needs among publicly insured youth, which are exacerbated for youth with multiple marginalized identities and those who do not conform to historical stereotypes of affected individuals (e.g., low-income boys of color with EDs). Targeted efforts are needed to ensure equitable care.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s003329172510069x","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T14:46:26Z","timestamp":1750776386000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["A transdiagnostic examination of sex- and race and ethnicity-based mental health treatment disparities among publicly insured youth"],"prefix":"10.1017","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5521-6381","authenticated-orcid":false,"given":"Erin C.","family":"Accurso","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9262-3683","authenticated-orcid":false,"given":"Megan E.","family":"Mikhail","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate Duggento","family":"Cordell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda E.","family":"Downey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lonnie R.","family":"Snowden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"S003329172510069X_r54","doi-asserted-by":"publisher","DOI":"10.1037\/a0028015"},{"key":"S003329172510069X_r47","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.4437"},{"key":"S003329172510069X_r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2016.05.004"},{"key":"S003329172510069X_r38","doi-asserted-by":"publisher","DOI":"10.1002\/eat.23402"},{"key":"S003329172510069X_r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2023.11.006"},{"key":"S003329172510069X_r16","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.21951"},{"key":"S003329172510069X_r19","first-page":"121","article-title":"Psychopharmacology of eating disorders in children and adolescents","volume":"58","author":"Golden","year":"2011","journal-title":"Pediatric Clinics"},{"key":"S003329172510069X_r29","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-016-0213-2"},{"key":"S003329172510069X_r48","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v4.i4.133"},{"key":"S003329172510069X_r51","doi-asserted-by":"publisher","DOI":"10.1037\/a0013877"},{"key":"S003329172510069X_r55","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwh090"},{"key":"S003329172510069X_r2","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24320"},{"key":"S003329172510069X_r8","doi-asserted-by":"publisher","DOI":"10.1111\/eip.13497"},{"key":"S003329172510069X_r14","doi-asserted-by":"publisher","DOI":"10.1177\/1363461517731702"},{"key":"S003329172510069X_r1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2023.08.019"},{"key":"S003329172510069X_r31","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-020-00323-9"},{"key":"S003329172510069X_r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2019.05.012"},{"key":"S003329172510069X_r3","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12638"},{"key":"S003329172510069X_r6","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20152"},{"key":"S003329172510069X_r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2021.102087"},{"key":"S003329172510069X_r35","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2023.2202236"},{"key":"S003329172510069X_r45","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2019.04.001"},{"key":"S003329172510069X_r46","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.17080844"},{"key":"S003329172510069X_r53","doi-asserted-by":"publisher","DOI":"10.1126\/science.1230817"},{"key":"S003329172510069X_r17","doi-asserted-by":"publisher","DOI":"10.1080\/07317100802701228"},{"key":"S003329172510069X_r52","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.9.1652"},{"key":"S003329172510069X_r4","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2017.1294739"},{"key":"S003329172510069X_r9","unstructured":"Centers for Medicare and Medicaid Services. (2017). Medicaid & CHIP: Strengthening coverage, improving health. https:\/\/www.medicaid.gov\/medicaid\/downloads\/accomplishments-report.pdf"},{"key":"S003329172510069X_r25","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1359"},{"key":"S003329172510069X_r33","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600498"},{"key":"S003329172510069X_r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2014.08.003"},{"key":"S003329172510069X_r24","doi-asserted-by":"publisher","DOI":"10.1080\/10640266.2016.1207455"},{"key":"S003329172510069X_r34","first-page":"20","article-title":"Barriers to help-seeking, detection, and adequate treatment for anxiety and mood disorders: Implications for health care policy","volume":"68","author":"Mechanic","year":"2007","journal-title":"Journal of Clinical Psychiatry"},{"key":"S003329172510069X_r41","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-014-0538-0"},{"key":"S003329172510069X_r12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2018.07.896"},{"key":"S003329172510069X_r39","doi-asserted-by":"publisher","DOI":"10.1002\/ajcp.12516"},{"key":"S003329172510069X_r44","doi-asserted-by":"publisher","DOI":"10.1126\/science.aay0214"},{"key":"S003329172510069X_r43","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.04.026"},{"key":"S003329172510069X_r32","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22536"},{"key":"S003329172510069X_r20","first-page":"193","article-title":"Family-based treatment of eating disorders: A narrative review","volume":"42","author":"Gorrell","year":"2019","journal-title":"Psychiatric Clinics"},{"key":"S003329172510069X_r15","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2022.2109650"},{"key":"S003329172510069X_r30","doi-asserted-by":"publisher","DOI":"10.1080\/17522439.2021.2001561"},{"key":"S003329172510069X_r13","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-024-01124-7"},{"key":"S003329172510069X_r7","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2021.1941058"},{"key":"S003329172510069X_r11","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.160.1.93"},{"key":"S003329172510069X_r36","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24301"},{"key":"S003329172510069X_r37","unstructured":"Mikhail, M. E. , Cordell, K. , Downey, A. E. , Snowden, L. R. , & Accurso, E. C. In press. Outpatient therapy and risk of rehospitalization for youth with eating disorders. Pediatrics."},{"key":"S003329172510069X_r42","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.180943"},{"key":"S003329172510069X_r23","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22249"},{"key":"S003329172510069X_r26","doi-asserted-by":"publisher","DOI":"10.1007\/s10826-015-0351-z"},{"key":"S003329172510069X_r10","unstructured":"Centers for Medicare and Medicaid Services. (2020). Race and ethnicity of the national Medicaid and CHIP population in 2020. https:\/\/www.medicaid.gov\/medicaid\/data-and-systems\/downloads\/macbis\/2020-race-etncity-data-brf.pdf"},{"key":"S003329172510069X_r40","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-022-00730-7"},{"key":"S003329172510069X_r49","doi-asserted-by":"publisher","DOI":"10.2174\/157340006778018102"},{"key":"S003329172510069X_r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2020.07.003"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S003329172510069X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T14:46:28Z","timestamp":1750776388000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S003329172510069X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":54,"alternative-id":["S003329172510069X"],"URL":"https:\/\/doi.org\/10.1017\/s003329172510069x","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e170"}}