The American Psychiatric Association (APA) has updated its Privacy Policy and Terms of Use, including with new information specifically addressed to individuals in the European Economic Area. As described in the Privacy Policy and Terms of Use, this website utilizes cookies, including for the purpose of offering an optimal online experience and services tailored to your preferences.

Please read the entire Privacy Policy and Terms of Use. By closing this message, browsing this website, continuing the navigation, or otherwise continuing to use the APA's websites, you confirm that you understand and accept the terms of the Privacy Policy and Terms of Use, including the utilization of cookies.

×
Published Online:

Objectives:

Data are limited on how clinicians contribute to outcome differences between black patients and white patients. Because the clinician-patient relationship is the foundation of mental health services, understanding clinicians' role in outcome differences may help identify evidence-based interventions that decrease disparities and capitalize on positive differences. Symptoms and functioning in a sample of black and white adults receiving outpatient services were examined to determine the effects of their primary clinician on those patterns.

Methods:

The study included 551 patients (25% black) with serious mental illness and 62 mental health professionals (21% black) identified as the patients' primary clinician. Treatment outcomes were measured at baseline and two follow-ups (two and four months) with the Behavior and Symptom Identification Scale, a measure of symptoms and functioning. Data were analyzed with hierarchical linear modeling. Clinicians' levels of multicultural competence, burnout, and education were analyzed.

Results:

Clinicians moderated the relationship between patient race and outcome differences. There was significant variability among clinicians: approximately 20% had black patients whose outcomes were worse than those of their white patients, and 40% had black patients with better outcomes than their white patients. The only clinician factor predicting these differences was clinician's general experiences and relationships with people from racial-ethnic and cultural groups other than their own.

Conclusions:

The occurrence of outcome differences varied across clinicians, with some clinicians magnifying outcome differences between black and white patients and others minimizing them. Factors other than clinicians' race, multicultural competence, education, and burnout may contribute to outcome differences between black and white patients. (Psychiatric Services 62:525–531, 2011)