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Racial/ethnic differences in perception of need for mental health treatment in a US national sample

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Abstract

Purpose

To resolve contradictory evidence regarding racial/ethnic differences in perceived need for mental health treatment in the USA using a large and diverse epidemiologic sample.

Methods

Samples from 6 years of a repeated cross-sectional survey of the US civilian non-institutionalized population were combined (N = 232,723). Perceived need was compared across three non-Hispanic groups (whites, blacks and Asian-Americans) and two Hispanic groups (English interviewees and Spanish interviewees). Logistic regression models were used to test for variation across groups in the relationship between severity of mental illness and perceived need for treatment.

Results

Adjusting statistically for demographic and socioeconomic characteristics and for severity of mental illness, perceived need was less common in all racial/ethnic minority groups compared to whites. The prevalence difference (relative to whites) was smallest among Hispanics interviewed in English, −5.8% (95% CI −6.5, −5.2%), and largest among Hispanics interviewed in Spanish, −11.2% (95% CI −12.4, −10.0%). Perceived need was significantly less common among all minority racial/ethnic groups at each level of severity. In particular, among those with serious mental illness, the largest prevalence differences (relative to whites) were among Asian-Americans, −23.3% (95% CI −34.9, −11.7%) and Hispanics interviewed in Spanish, 32.6% (95% CI −48.0, −17.2%).

Conclusions

This study resolves the contradiction in empirical evidence regarding the existence of racial/ethnic differences in perception of need for mental health treatment; differences exist across the range of severity of mental illness and among those with no mental illness. These differences should be taken into account in an effort to reduce mental health-care disparities.

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Acknowledgements

This work was supported by Grants from the National Institute on Minority Health and Health Disparities (R01 MD010274) and the National Institute of Mental Health (R01 MH104381).

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Authors and Affiliations

  1. RAND Corporation, 4570 Fifth Avenue, Pittsburgh, PA, 15213, USA

    Joshua Breslau & Gerald P. Hunter

  2. RAND Corporation, 1776 Main Street, Santa Monica, California, USA

    Matthew Cefalu, Eunice C. Wong, M. Audrey Burnam & Rebecca L. Collins

  3. City University of New York School of Public Health, New York, USA

    Karen R. Florez

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  1. Joshua Breslau
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  2. Matthew Cefalu
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  3. Eunice C. Wong
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  4. M. Audrey Burnam
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  7. Rebecca L. Collins
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Correspondence to Joshua Breslau.

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Breslau, J., Cefalu, M., Wong, E. et al. Racial/ethnic differences in perception of need for mental health treatment in a US national sample. Soc Psychiatry Psychiatr Epidemiol 52, 929–937 (2017). https://doi.org/10.1007/s00127-017-1400-2

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  • DOI: https://doi.org/10.1007/s00127-017-1400-2

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