- Black and Latinos initiate care for mental health concerns less often than Whites.
- Blacks were more likely to have an episode of care in a psychiatric emergency department or inpatient facility than Whites.
Blacks and Latinos receive less adequate mental health care than Whites, finds a new study in Health Services Research.
“We found that Blacks and Latinos [remain] in care, including using outpatient services and filling psychotropic drugs, for a shorter time than whites,” said lead study author, Benjamin Le Cook, Ph.D. M.P.H., assistant professor in the department of psychiatry at Harvard Medical School. “Furthermore, since Blacks often wait longer to get help, they are more likely to end up in a psychiatric ER or psychiatric inpatient facility to treat their mental illness.”
The study also found significant differences in how people seek mental health care. “For those who do make it to care, African-Americans and Latinos have episodes of care that are shorter in duration,” said Le Cook.
Le Cook and his colleagues analyzed data from the responses of 47,903 White, Black and Latino adults age 18 and over to mental health questions in the Medical Expenditure Panel Survey (MEPS) regarding probable need for mental health or substance abuse care.
They found that while 40 percent of Whites with a probable need for mental health care sought treatment, only 27 percent of Latinos and 24 percent of Blacks did. Efforts to reduce disparities in seeking care might focus on improving identification of clinical need among minorities, access to mental health systems of care in minority communities, and initial engagement in treatment by minorities, the researchers suggest.
“Access drives quality of mental health care, and improved quality is needed, but education and engagement are vitally important,” comments Erica Ahmed, director of public education at Mental Health America in Alexandria, Virginia.
Mental health literacy is complex and engagement is contingent on many factors like poverty, citizenship, race and isolation, said Ahmed. “You can live in an urban area but you can still be isolated when it comes to accessing mental health care.”
When the Patient Protection and Affordable Care Act is implemented, Le Cook said better insurance coverage will likely help Blacks and Latinos, but there are still disparities.
“While insurance increases mental health access, adequacy of care is low for those with and without insurance and a number of insured individuals fill and refill psychotropic medications without any patient follow-up,” he noted. “These problems are not likely to be eliminated after insurance coverage expansion.”
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Health Services Research is the official journal of the Academy Health and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422 2646 or firstname.lastname@example.org. HSR is available online at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1475-6773/