Effect of Proposition 187 on Mental Health Service Use in California: A Case Study

Health Affairs

Volumn 15, Issue 1, 1996, Pages

  Fenton, Joshua J ^a   Catalano, Ralph ^b   Hargreaves, William A ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; CRISIS INTERVENTION; FEMALE; HEALTH CARE DELIVERY; HEALTH CARE PLANNING; HISPANIC; HUMAN; LEGAL ASPECT; MALE; MENTAL HEALTH SERVICE; MIDDLE AGED; MIGRATION; ORGANIZATION AND MANAGEMENT; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

ADOLESCENT; ADULT; CALIFORNIA; COMMUNITY MENTAL HEALTH SERVICES; CRISIS INTERVENTION; ELIGIBILITY DETERMINATION; EMIGRATION AND IMMIGRATION; FEMALE; HEALTH SERVICES ACCESSIBILITY; HISPANIC AMERICANS; HUMANS; MALE; MIDDLE AGED; STATE HEALTH PLANS; UNITED STATES;

EID: 0442281215     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.15.1.182     Document Type: Article

References (26)

1. California Ballot Pamphlet: General Election (Sacramento: Secretary of State, 1994), 92-94.
2. L. Romney, "Youth Dies as Medical Treatment Is Delayed," Los Angeles Times, 23 November 1994, A3; P. Burdman, "Woman Who Feared Prop. 187 Deportation Dies at S.F. General," The San Francisco Chronicle, 26 November 1994, A14; M. Cabanatuan, "Clinic Use Drops: Fewer Hispanics in Prenatal Care," The Modesto Bee, 22 March 1995, A1; and A.M. Marin, "The Effects of Proposition 187: A First-Hand Report from San Diego County," California Family Physician (May/June 1995): 10.
3. L. Romney, "Youth Dies as Medical Treatment Is Delayed," Los Angeles Times, 23 November 1994, A3; P. Burdman, "Woman Who Feared Prop. 187 Deportation Dies at S.F. General," The San Francisco Chronicle, 26 November 1994, A14; M. Cabanatuan, "Clinic Use Drops: Fewer Hispanics in Prenatal Care," The Modesto Bee, 22 March 1995, A1; and A.M. Marin, "The Effects of Proposition 187: A First-Hand Report from San Diego County," California Family Physician (May/June 1995): 10.
4. L. Romney, "Youth Dies as Medical Treatment Is Delayed," Los Angeles Times, 23 November 1994, A3; P. Burdman, "Woman Who Feared Prop. 187 Deportation Dies at S.F. General," The San Francisco Chronicle, 26 November 1994, A14; M. Cabanatuan, "Clinic Use Drops: Fewer Hispanics in Prenatal Care," The Modesto Bee, 22 March 1995, A1; and A.M. Marin, "The Effects of Proposition 187: A First-Hand Report from San Diego County," California Family Physician (May/June 1995): 10.
5. L. Romney, "Youth Dies as Medical Treatment Is Delayed," Los Angeles Times, 23 November 1994, A3; P. Burdman, "Woman Who Feared Prop. 187 Deportation Dies at S.F. General," The San Francisco Chronicle, 26 November 1994, A14; M. Cabanatuan, "Clinic Use Drops: Fewer Hispanics in Prenatal Care," The Modesto Bee, 22 March 1995, A1; and A.M. Marin, "The Effects of Proposition 187: A First-Hand Report from San Diego County," California Family Physician (May/June 1995): 10.
6. D. Ayres, "Federal Judge Voids Some Limits on California's Services to Aliens," The New York Times, 22 November 1995, C18; and L. Mecoy, "State Says Prop. 187 Affects 23 Programs: Illegal Immigrants Excluded from Just Two of Them Initially," The San Francisco Examiner, 1 February 1996, A5.
7. D. Ayres, "Federal Judge Voids Some Limits on California's Services to Aliens," The New York Times, 22 November 1995, C18; and L. Mecoy, "State Says Prop. 187 Affects 23 Programs: Illegal Immigrants Excluded from Just Two of Them Initially," The San Francisco Examiner, 1 February 1996, A5.
8. Immigration in the National Interest Act: H.R. 2202, Passed from Judiciary Committee, 104th Congress (1995); Ayres, "Federal Judge Voids Some Limits;" and D. Bowermaster, "Closing the Golden Door: Political Debate over Legal and Illegal Immigration," U.S. News and World Report (25 September 1995); 42.
9. Immigration in the National Interest Act: H.R. 2202, Passed from Judiciary Committee, 104th Congress (1995); Ayres, "Federal Judge Voids Some Limits;" and D. Bowermaster, "Closing the Golden Door: Political Debate over Legal and Illegal Immigration," U.S. News and World Report (25 September 1995); 42.
10. C.A. Evans, "Immigrants and Health Care: Mounting Problems," Annals of Internal Medicine 122, no. 4 (1995): 309-310.
11. Department of Public Health, Division of Mental Health, Substance Abuse, and Forensic Services, Revised Adult Target Population Criteria (City and County of San Francisco, May 1995).
12. In July 1993, concurrent with new policies emphasizing outpatient and community treatment, the DMS began recording service episodes at many service sites that were not previously accounted for in computerized data. Consequently, the level of detail and the quantity of services recorded in the DMS data files after July 1993 are much greater than in prior months.
13. The ethnicity of patients is usually specified by DMS service providers, rather than by individual patients.
14. L.R. Chavez, W.A. Cornelius, and O.W. Jones, "Mexican Immigrants and the Utilization of U.S. Health Services: The Case of San Diego," Social Science and Medicine 21, no. 1 (1985): 93-102.
15. The five key service sites for Hispanic immigrants were originally identified by social workers and clinicians at the Latino Focus Psychiatric Inpatient Unit at San Francisco General Hospital, all of whom are familiar with community-based service sites providing bilingual or culturally sensitive mental health services. We then validated these suggested service sites with DMS administrators.
16. For each individual diagnosis, we used the DSM-III-R Axis I diagnosis listed for each person's earliest outpatient or crisis episode during the study time period. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (Washington: American Psychiatric Association, 1987). Readers should note that DSM diagnoses may change depending on the setting in which services are provided and the familiarity of the service provider with the patient. For example, the higher rates of adjustment disorders and unspecified psychosis diagnoses in crisis settings most likely reflect the difficulty of diagnosing persistent mental illness without an extended relationship with a patient.
17. G.E.P. Box, G.M. Jenkins, and G. Reinsel, Time Series Analysis: Forecasting and Control, 3d ed. (Englewood Cliffs, N.J.: Prentice Hall, 1994). For a less technical discussion of these methods, see R. Catalano and S. Serxner, "Time Series Designs of Potential Interest to Epidemiologists," American Journal of Epidemiology 126, no. 4 (1987): 724-731.
18. G.E.P. Box, G.M. Jenkins, and G. Reinsel, Time Series Analysis: Forecasting and Control, 3d ed. (Englewood Cliffs, N.J.: Prentice Hall, 1994). For a less technical discussion of these methods, see R. Catalano and S. Serxner, "Time Series Designs of Potential Interest to Epidemiologists," American Journal of Epidemiology 126, no. 4 (1987): 724-731.
19. Space precludes full methodological discussion. Details are available from the authors at San Francisco General Hospital, Department of Psychiatry, Room 7M-W21, 1001 Potrero Avenue, San Francisco, California 94110.
20. The addition of older Hispanics to the model ensured that the observed effect on crisis episodes among young Hispanics was unique to young Hispanics, rather than a general effect observed among all Hispanics.
21. J. Fenton et al., "The Effect of California's Proposition 187 on Health Service Use: Preliminary Results of a Statewide Clinic Survey" (Abstract, American Public Health Association Annual Meeting, San Diego, California, 1 November 1995); Romney, "Youth Dies as Medical Treatment Is Delayed;" Burdman, "Woman . . . Dies at S.F. General;" Cabanatuan, "Clinic Use Drops;" and Marin, "The Effects of Proposition 187."
22. J. Fenton et al., "The Effect of California's Proposition 187 on Health Service Use: Preliminary Results of a Statewide Clinic Survey" (Abstract, American Public Health Association Annual Meeting, San Diego, California, 1 November 1995); Romney, "Youth Dies as Medical Treatment Is Delayed;" Burdman, "Woman . . . Dies at S.F. General;" Cabanatuan, "Clinic Use Drops;" and Marin, "The Effects of Proposition 187."
23. J. Fenton et al., "The Effect of California's Proposition 187 on Health Service Use: Preliminary Results of a Statewide Clinic Survey" (Abstract, American Public Health Association Annual Meeting, San Diego, California, 1 November 1995); Romney, "Youth Dies as Medical Treatment Is Delayed;" Burdman, "Woman . . . Dies at S.F. General;" Cabanatuan, "Clinic Use Drops;" and Marin, "The Effects of Proposition 187."
24. J. Fenton et al., "The Effect of California's Proposition 187 on Health Service Use: Preliminary Results of a Statewide Clinic Survey" (Abstract, American Public Health Association Annual Meeting, San Diego, California, 1 November 1995); Romney, "Youth Dies as Medical Treatment Is Delayed;" Burdman, "Woman . . . Dies at S.F. General;" Cabanatuan, "Clinic Use Drops;" and Marin, "The Effects of Proposition 187."
25. J. Fenton et al., "The Effect of California's Proposition 187 on Health Service Use: Preliminary Results of a Statewide Clinic Survey" (Abstract, American Public Health Association Annual Meeting, San Diego, California, 1 November 1995); Romney, "Youth Dies as Medical Treatment Is Delayed;" Burdman, "Woman . . . Dies at S.F. General;" Cabanatuan, "Clinic Use Drops;" and Marin, "The Effects of Proposition 187."
26. R. Sandoval and S. Ferriss, "The Dilemma of Immigration," Hispanic Business (February 1995): 18.