Ethnic Disparities in Mental Health Care

Depression less likely to be diagnosed and treated with minorities

(RxWiki News) It seems that racial and ethnic disparities still exist across the health care field, including mental health care - particularly for older people.

The National Institute of Mental Health (NIMH) funded a recent study to look at mental health disparities, especially among older adults.

Depression is a significant health concern for the older population, regardless of race or ethnicity. Disparities have been found in relation to depression in the general population, and in the NIMH-funded study this was looked at specifically for the older population.

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The findings suggest that depression continues to be under-recognized and under-treated among older minorities. The research team suggests that future research be done to investigate cultural factors such as help-seeking patterns, stigma, and patient attitudes and knowledge about depression.

Ethnic minorities may be less likely to seek help for a mood disorder, and those with lower incomes may have more difficulty gaining access to specialized health care.

Minorities tend to cite stigma or shame associated with having a mental disorder as a reason for not seeking help for depression, and African Americans tend to have a greater sense of distrust of doctors in general compared to white patients, said the researchers.

In addition, minority patients also may be more likely to present with more physical aspects of depression such as sleep problems or pain, rather than mood or cognitive symptoms, which can complicate detection and diagnosis of depression.

Using the nationally representative Medicare Current Beneficiary Survey (MCBS), Ayse Akincigil Ph.D., of Rutgers University and colleagues examined data from 2001 to 2005. The researchers looked at rates of depression diagnosis and treatment among older adults, including questions about health care use and costs, insurance coverage beyond Medicare, access to care, and use of services.

They found that about 6.4 percent of whites and 7.2 percent of Hispanics were diagnosed with depression, compared to 4.2 percent of African Americans. Among those diagnosed, 73 percent of whites received treatment (either with antidepressants, psychotherapy or both), while 60 percent of African Americans received treatment and 63.4 percent of Hispanics received treatment.

The researchers noted that these diagnosis and treatment differences are consistent with previous studies.

They also noted pronounced differences in socioeconomic status and quality of insurance coverage across ethnicities, although these differences did not appear to account for the disparities in diagnosis or treatment rates.

Research findings were published in a recent issue of the American Journal of Public Health.

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Review Date: 
February 2, 2012