Client-Case Manager Racial Matching in a Program for Homeless Persons With Serious Mental Illness

OBJECTIVE: This study evaluated the relationship between client-case manager racial matching and both service use and clinical outcomes in a case management program for homeless persons with serious mental illness. METHODS: The study focused on 1,785 clients from the first cohorts that entered the Center for Mental Health Services' Access to Community Care and Effective Services and Supports (ACCESS) program, a five-year demonstration program for homeless persons with mental illness established at 18 sites between 1994 and 1996. A series of two-way analyses of variance was used to assess the effect of client and case manager race and their interaction on changes in outcomes and service use over a 12-month period. RESULTS: Although African Americans had more severe problems on several measures and higher levels of service use at baseline, no differences in service use at 12 months or in the changes in client outcomes as measured by nine variables were associated with the different pairings of African-American and white clients and case managers. White clients had a greater reduction in psychotic symptoms than did African-American clients, regardless of client- case manager racial pairing. No differences were found between white and African-American clients on the amount of services received over time. CONCLUSIONS: This study found virtually no evidence of a relationship between client race, case manager race, or client-case manager racial matching on either outcomes or service use.