Gender and Racial/Ethnic Differences in Use of Outpatient Mental Health and Substance Use Services by Depressed Adults
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
This study examines depressed adults’ use of mental health services, focusing on Latinos and African Americans. Self-report data for adults meeting CIDI criteria for major depression or dysthymia from the 1997–98 HealthCare for Communities Survey were analyzed. Gender stratified logistic regression models examined the relationship between race/ethnicity and outpatient mental health service use, controlling for sociodemographic, health status, insurance, and geographic characteristics. Latinas and African American women and men exhibited low use of outpatient mental health services. Similar results were observed in an insured subsample. Service use by minorities was more affected by financial and social barriers (e.g., stigma). No gender differences were observed in self-reported barriers to care. Concerted and continued efforts to promote access to mental health services are critical for minority men and women affected by depression; adults may have unmet mental health needs. Other vulnerable populations include older adults especially, men, and men in poor health.
- Kessler R, Berglund P, Demler O, et al.: The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289(23):3095–3105, 2003. CrossRef
- Kessler RC: Gender differences in the prevalence and correlates of mood disorders in the general population. in Mood disorders in women, Edited by Steiner M, Yonkers KA, Eriksson E. London, UK: Martin Dunitz Ltd., 2000.
- Breslau J, Kendler KS, Su M, Gaxiola-Aguilar S, Kessler RC: Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States. Psychological Medicine 34:1–11, 2004. CrossRef
- Vega W, Kolody B, Aguilar-Gaxiola S, Alderete E, Catalano R, Caraveo-Anduaga J: Lifetime prevalence of DSM-IIIR psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry 55(9):771–778, 1998. CrossRef
- Grant BF, Stinson FS, Hasin DS, Dawson DA, Chou SP, Anderson K: Immigration and lifetime prevalence of DSM-IV psychiatric disorders among Mexican Americans and non-Hispanic whites in the united states: Results from the national Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 61:1226–1233, 2004. CrossRef
- McGuire TG, Wells KB, Bruce ML, et al.: Burden of illness. Mental Health Services Research 4(4):179–185, 2002. CrossRef
- Miranda J, Bernal G, Lau A, Kohn L, Hwang W-C, LaFromboise T: State of the science on psychosocial interventions for ethnic minorities. Annual Review of Psychology 1:113–142, 2005. CrossRef
- Institute of Medicine, ed. Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press; 2003.
- U.S. Department of Health and Human Services: Mental health: A report of the surgeon general. Rockville, MD., U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institute of Mental Health, 1999.
- U.S. Department of Health and Human Services: Mental health: Culture, race, and ethnicity– a supplement to mental health: A report of the surgeon general. Rockville, MD, U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001.
- Cleary P, Mechanic D, Greenley J: Sex differences in medical care utilization: An empirical approach. Journal of Health and Social Behavior 23(June):106–119, 1982. CrossRef
- Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pincus HA: National trends in the outpatient treatment of depression. Journal of the American Medical Association 287(2):203–209, 2002. CrossRef
- Vega WA, Kolody B, Aguilar-Gaxiola S, Catalano R: Gaps in service utilization by Mexican-Americans with mental health problems. American Journal of Psychiatry 156:928–934, 1999.
- Narrow WE, Regier DA, Norquist G, Rae DS, Kennedy C, Arons B: Mental health service use by Americans with severe mental illness. Social Psychiatry and Psychiatric Epidemiology 35:147–155, 2000. CrossRef
- Vega WA, Kolody B, Aguilar-Gaxiola S: Help-seeking for mental health problems among Mexican Americans. Journal of Immigrant Health 3(3):133–140, 2001. CrossRef
- Peifer KL, Hu T-w, Vega WA: Help seeking by persons of Mexican origin with functional impairments. Psychiatric Services 51(10):1293–1298, 2000. CrossRef
- Mojtabai R, Olfson M, Mechanic D: Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Archives of General Psychiatry 59:77–84, 2002. CrossRef
- Swartz MS, Wagner HR, Swanson JW, Burns LK, George LK, Padgett DK: Comparing use of public and private mental health services: The enduring barriers of race and age. Community Mental Health Journal 34(2):133–144, 1998. CrossRef
- Gallo JJ, Marino S, Ford D, Anthony JC: Filters on the pathway to mental health care, ii. Sociodemographic factors. Psychological Medicine 25(6):1149–1160, 1995. CrossRef
- Miranda J, Cooper LA: Disparities in care for depression among primary care patients. Journal of General Internal Medicine 19:120–126, 2004. CrossRef
- Alegria M, Canino G, Rios R, et al.: Inequalities in use of specialty mental health services among Latinos, African Americans, and non-latino whites. Psychiatric Services 53(12):1547–1555, 2002. CrossRef
- Wells KB, Klap R, Koike A, Sherbourne CD: Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. American Journal of Psychiatry 158(12):2027–2032, 2001. CrossRef
- Young AS, Klap R, Sherbourne CD, Wells KB: The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry 58(1):55–61, 2001. CrossRef
- Snowden L, Thomas K: Medicaid and African American outpatient mental health treatment. Mental Health Services Research 2(2):115–120, 2000. CrossRef
- Husaini BA, Sherkat DE, Levine R, et al.: Race, gender, and health care service utilization and costs among Medicare elderly with psychiatric diagnoses. Journal of Aging and Health 14(1):79–95, 2002. CrossRef
- Sturm R, Gresenz C, Sherbourne CD, et al.: The design of healthcare for communities: A study of health care delivery for alcohol, drug abuse, and mental health conditions. Inquiry 36(Summer):221–233, 1999.
- Wells KB, Sherbourne CD, Sturm R, Young AS, Burnam A: Alcohol, drug abuse, and mental health care for uninsured and insured adults. Health Services Research 37(4):1055–1066, 2002. CrossRef
- Gresenz C, Stockdale SE, Wells KB: Community effects on access to behavioral health care. Health Services Research 35(1):293–306, 2000.
- McGuire TG, Alegria M, Cook BL, Wells KB, Zaslavsky A: Implementing the IOM definition of disparities: An application to mental health care. Unpublished, 2005.
- United States Department of Health and Human Services. HHS regional offices. Available at: http://www.hhs.gov/about/regions/. Accessed July, 2004.
- Albizu-Garcia CE, Alegria M, Freeman D, Vera M: Gender and health services use for a mental health problem. Social Science and Medicine 53:865–878, 2001. CrossRef
- U.S. Census Bureau Population Division. Projections of the resident population by race, Hispanic origin, and nativity: Middle series, 2025–2045. January 13, 2000.
- Wells KB, Sherbourne CD, Schoenbaum M, et al.: Five-year impact of quality improvement for depression. Archives of General Psychiatry 61:378–386, 2004. CrossRef
- Lebowitz BD, Pearson JL, Schneider LS, et al.: Diagnosis and treatment of depression in late life: Consensus statement update. Journal of the American Medical Association 278(14):1186–1190, 1997. CrossRef
- Crystal S, Sambamoorthi U, Walkup J, Akincigil A: Diagnosis and treatment of depression in the elderly Medicare population: Predictors, disparities, and trends. Journal of the American Geriatrics Society 51:1718–1728, 2003. CrossRef
- Gottfries C-G: Depression in the elderly. in Mood disorders in women, Edited by Steiner M, Yonkers KA, Eriksson E. London, England: Martin Dunitz, 2000.
- Gender and Racial/Ethnic Differences in Use of Outpatient Mental Health and Substance Use Services by Depressed Adults
Volume 77, Issue 3 , pp 211-222
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- African Americans
- Mental health services
- Access to care