Disparity in Depression Treatment Among Racial and Ethnic Minority Populations in the United States

Margarita M. Alegria · Pinka Chatterji · Kenneth Brooks Wells · Zhun Cao · Chih‐Nan Chen · David T. Takeuchi +2 more

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Mental Health Treatment and Access Health disparities and outcomes Cultural Competency in Health Care

Abstract

OBJECTIVE: Prior research on racial and ethnic disparities in depression treatment has been limited by the scarcity of national samples that include an array of diagnostic and quality indicators and substantial numbers of non-English-speaking individuals from minority groups. Using nationally representative data for 8,762 persons, the authors evaluated differences in access to and quality of depression treatments between patients in racial-ethnic minority groups and non-Latino white patients. METHODS: Access to mental health care was assessed by past-year receipt of any mental health treatment. Adequate treatment for acute depression was defined as four or more specialty or general health provider visits in the past year plus antidepressant use for 30 days or more or eight or more specialty mental health provider visits lasting at least 30 minutes, with no antidepressant use. RESULTS: For persons with past-year depressive disorder, 63.7% of Latinos, 68.7% of Asians, and 58.8% of African Americans, compared with 40.2% of non-Latino whites, did not access any past-year mental health treatment (significantly different at p<.001). Disparities in the likelihood of both having access to and receiving adequate care for depression were significantly different for Asians and African Americans in contrast to non-Latino whites. CONCLUSIONS: Simply relying on present health care systems without consideration of the unique barriers to quality care that ethnic and racial minority populations face is unlikely to affect the pattern of disparities observed. Populations reluctant to visit a clinic for depression care may have correctly anticipated the limited quality of usual care.

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References

2004The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)2005Twelve-Month Use of Mental Health Services in the United States 1995Collaborative management to achieve treatment guidelines. Impact on depression in primary care

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