Patient-clinician ethnic concordance and communication in mental health intake visits

OBJECTIVE: This study examines how communication patterns vary across racial and ethnic patient-clinician dyads in mental health intake sessions and its relation to continuance in treatment, defined as attending the next scheduled appointment.METHODS: Observational study of communication patterns among ethnically/racially concordant and discordant patient-clinician dyads. Primary analysis included 93 patients with 38 clinicians in race/ethnic concordant and discordant dyads. Communication was coded using the Roter Interaction Analysis System (RIAS) and the Working Alliance Inventory Observer (WAI-O) bond scale; continuance in care was derived from chart reviews.RESULTS: Latino concordant dyad patients were more verbally dominant (p.05), engaged in more patient-centered communication (p.05) and scored higher on the (WAI-O) bond scale (all p.05) than other groups. Latino patients had higher continuance rates than other patients in models that adjusted for non-communication variables. When communication, global affect, and therapeutic process variables were adjusted for, differences were reversed and white dyad patients had higher continuance in care rates than other dyad patients.CONCLUSION: Communication patterns seem to explain the role of ethnic concordance for continuance in care.PRACTICE IMPLICATIONS: Improve intercultural communication in cross cultural encounters appears significant for retaining minorities in care.