Skip to main content

Advertisement

SpringerLink
Log in

Racial/Ethnic Differences in Contemporaneous Use of Mental Health and Substance Use Treatment Among Individuals Experiencing Both Mental Illness and Substance Use Disorders

  • Original Paper
  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

This study examined whether the well-established racial/ethnic differences in mental health service utilization among individuals with mental illness are reflected in the treatment utilization patterns of individuals experiencing both mental illness and substance use disorders, particularly in regards to the use of contemporaneous mental health and substance abuse treatment. Using pooled data from the National Survey on Drug Use and Health (2009–2013), the patterns of mental health and substance use treatment utilization of 8748 White, Black, or Latino individuals experiencing both mental illness and substance use disorders were analyzed. Multinomial logistic regression was conducted to test the relationships among racial/ethnic groups and the receipt of contemporaneous treatment, mental health treatment alone, and substance use treatment alone as compared with no treatment utilization. Results indicated that Black and Latino respondents were less likely to receive contemporaneous treatment than Whites respondents. Also, significantly associated with outcomes were several interactions between race/ethnicity and predisposing, need and enabling factors known to be associated with service utilization. The findings suggest that an underlying mechanism of racial/ethnic differences among individuals with co-occurring mental illness and substance use disorders in the treatment utilization may differ by the specific types of treatment and between Blacks and Latinos. Therefore, efforts to reduce these disparities should consider specialty in each treatment settings and heterogeneity within diverse racial/ethnic groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Grant BF, Stinson FS, Dawson DA, et al.: Prevalence and co-occurrence of substance use disorders and independentmood and anxiety disorders: Results from the national epidemiologic survey on alcohol and relatedconditions. Archives of General Psychiatry 61(8):807–816, 2004

    Article  PubMed  Google Scholar 

  2. Kessler RC, Chiu WT, Demler O, et al.: Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62(6):617–627, 2005

    Article  PubMed  PubMed Central  Google Scholar 

  3. Drake RE, Brunette MF: Complications of Severe Mental Illness Related to Alcohol and Drug use Disorders. In: Galanter M (Ed) Recent Developments in Alcoholism. New York, Springer, 1998

    Google Scholar 

  4. Drake RE, Mueser KT, Clark RE, et al.: The course, treatment, and outcome of substance disorder in persons with sevre mental illness. American Journal of Orthopsychiatry 66(1):42–51, 1996

    Article  CAS  PubMed  Google Scholar 

  5. Dickey B, Normand SLT, Weiss RD, Azeni H, et al.: Medical morbidity, mental illness, and substance use disorders. Psychiatric Services 53(7):861–867, 2002

    Article  PubMed  Google Scholar 

  6. Osher FC, Goldberg RW, McNary SW, et al.: Blood-borne infections and persons with mental illness: Substance abuse and the transmission of hepatitis C among persons with severe mental illness. Psychiatric Services 54(6):842–847, 2003

    Article  PubMed  Google Scholar 

  7. McGovern MP, Lambert-Harris C, Acquilano S, Xie H, Alterman AI, Weiss RD: A cognitive behavioral therapy for co-occurring substance use and posttraumatic stress disorders. Addictive Behaviors 34(10):892–897, 2009

    Article  PubMed  PubMed Central  Google Scholar 

  8. McGovern MP, Lambert‐Harris C, Xie H, Meier A, McLeman B, Saunders E: A randomized controlled trial of treatments for co‐occurring substance use disorders and post‐traumatic stress disorder. Addiction 110(7):1194–1204, 2015

    Article  PubMed  PubMed Central  Google Scholar 

  9. Mueser KT, Noordsy DL, Drake RE, et al.: Integrated Treatment for Dual Disorders: A Guide to Effective Practice. New York, Guilford Press, 2003

    Google Scholar 

  10. Minkoff K: Best practices: Developing standards of care for individuals with co-occurring psychiatric and substance use disorders. Psychiatric Services 52(5):597–599, 2001

    Article  CAS  PubMed  Google Scholar 

  11. Watkins KE, Burnam A, Kung FY, et al.: A national survey of care for persons with co-occurring mental and substance use disorders. Psychiatric Services 52(8):1062–1068, 2001

    Article  CAS  PubMed  Google Scholar 

  12. Harris KM, Edlund MJ: Use of mental health care and substance abuse treatment among adults with co-occurring disorders. Psychiatric Services 56(8):954–959, 2005

    Article  PubMed  Google Scholar 

  13. Havassy BEP, Alvidrez J, Mericle AAP: Disparities in use of mental health and substance abuse services by persons with co-occurring disorders. Psychiatric Services 60(2):217–223, 2009

    Article  PubMed  PubMed Central  Google Scholar 

  14. Snowden LR, Yamada AM: Cultural differences in access to care. Annual Review of Clinical Psychology 1:143–166, 2005

    Article  PubMed  Google Scholar 

  15. Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD: Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment 61:47–59, 2016

    Article  PubMed  Google Scholar 

  16. Wang PS, Lane M, Olfson M, et al.: Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry 62(6):629–640, 2005

    Article  PubMed  Google Scholar 

  17. Alegría M, Chatterji P, Wells K, et al.: Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric Services 59(11):1264–1272, 2008

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cohen E, Feinn R, Arias A, et al: Alcohol treatment utilization: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence 86(2):214–221, 2007

    Article  PubMed  Google Scholar 

  19. Schmidt LA, Ye Y, Greenfield TK, et al.: Ethnic disparities in clinical severity and services for alcohol problems: results from the National Alcohol Survey. Alcoholism: Clinical and Experimental Research 31(1):48–56, 2007

    Article  Google Scholar 

  20. Alvidrez J, Havassy BE: Racial distribution of dual-diagnosis clients in public sector mental health and drug treatment settings. Journal of Health Care for the Poor and Underserved 16(1):53–62, 2005

    Article  PubMed  Google Scholar 

  21. Hatzenbuehler ML, Keyes KM, Narrow WE, et al.: Racial/ethnic disparities in service utilization for individuals with co-occurring mental health and substance use disorders in the general population. The Journal of Clinical Psychiatry 69(7):1112–1121, 2008

    Article  PubMed  PubMed Central  Google Scholar 

  22. Guerrero EG, Marsh JC, Khachikian T, et al.: Disparities in Latino substance use, service use, and treatment: Implications for culturally and evidence-based interventions under health care reform. Drug and Alcohol Dependence 133(3):805–813, 2013

    Article  PubMed  Google Scholar 

  23. Substance Abuse and Mental Health Servicse Administration: Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD, SAMHSA, 2014

    Google Scholar 

  24. Substance Abuse and Mental Health Servicse Administration: 2013 National Survey on Drug Use and Health Public Use File Codebook. Rockville, MD, SAMMHA, 2014

    Google Scholar 

  25. Colpe LJ, Epstein JF, Barker PR, et al.: Screening for serious mental illness in the National Survey on Drug Use and Health (NSDUH). Annals of Epidemiology 19(3):210–211, 2009

    Article  PubMed  Google Scholar 

  26. Gfroerer J, Hedden S, Barker P, et al.: Estimating mental illness in an ongoing national survey. 2012 available at: https://fcsm.sites.usa.gov/files/2014/05/Gfroerer_2012FCSM_VII-A.pdf

  27. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC, American Psychiatric Association, 1994

    Google Scholar 

  28. Office of Management and Budget: Revisions to the standards for the classification of federal data on race and ethnicity. Federal Register 62(210):58781–58790, 1997

    Google Scholar 

  29. Andersen RM: Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior 36:1–10, 1995

    Article  CAS  PubMed  Google Scholar 

  30. Andersen RM, Newman JF: Societal and individual determinants of medical care utilization in the United States. Milbank Quarterly 83(4):1–28, 2005

    Article  Google Scholar 

  31. Matejkowski J, Lee S, Han W: The association between criminal history and mental health service use among people with serious mental illness. Psychiatric Quarterly 85:9–24, 2014

    Article  PubMed  Google Scholar 

  32. Substance Abuse and Mental Health Services Administration: Treatment Episode Data Set (TEDS), 2002–2012. Rockville, MD, SAMMHA, 2014

    Google Scholar 

  33. Rao JNK, Scott AJ: On chi-squared tests for multiway contingency tables with cell proportions estimated from survey data. Annals of Statistics 12:46–60, 1984

    Article  Google Scholar 

  34. Edlund MJ, Booth BM, Han X: Who seeks care where? Utilization of mental health and substance use disorder treatment in two national samples of individuals with alcohol use disorders. Journal of Studies on Alcohol and Drugs 73(4):635–646, 2012

    Article  PubMed  PubMed Central  Google Scholar 

  35. Chen LY, Crum RM, Martins SS, Kaufmann CN, Strain EC, Mojtabai R: Service use and barriers to mental health care among adults with major depression and comorbid substance dependence. Psychiatric Services 64(9):863–870, 2013

    Article  PubMed  PubMed Central  Google Scholar 

  36. Neighbors HW, Caldwell C, Williams DR, Nesse R, Taylor RJ, Bullard KM, et al.: Race, ethnicity, and the use of services for mental disorders: Results from the National Survey of American Life. Archives of General Psychiatry 64(4):485–494, 2007

    Article  PubMed  Google Scholar 

  37. Snowden LR: Health and mental health policies’ role in better understanding and closing African American–White American disparities in treatment access and quality of care. American Psychologist 67(7):524–531, 2012

    Article  PubMed  Google Scholar 

  38. Lee S, Laiewski L, Choi S: Racial-ethnic variation in US mental health service use among Latino and Asian non-US citizens. Psychiatric Services 65(1):68–74, 2014

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Social Welfare, University of Kansas, Twente Hall, 1545 Lilac Lane, Lawrence, KS, 66045, USA

    Eunji Nam & Jason Matejkowski

  2. School of Social Welfare, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul, South Korea

    Sungkyu Lee

Authors
  1. Eunji Nam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason Matejkowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sungkyu Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eunji Nam.

Ethics declarations

Conflict of Interest

All authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nam, E., Matejkowski, J. & Lee, S. Racial/Ethnic Differences in Contemporaneous Use of Mental Health and Substance Use Treatment Among Individuals Experiencing Both Mental Illness and Substance Use Disorders. Psychiatr Q 88, 185–198 (2017). https://doi.org/10.1007/s11126-016-9444-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11126-016-9444-0

Keywords

Search

Navigation