National trends in ethnic disparities in mental health care.

Abstract:

OBJECTIVE:To compare trends in office-based treatment of mental disorders between Hispanics and non-Hispanics. DESIGN, SETTING, AND PARTICIPANTS:Analysis of a nationally representative sample of visits to office-based physicians conducted between 1993 and 2002 (N = 251,905). Visits were grouped into 3 discrete time periods, 1993-1996, 1997-1999 and 2000-2002. MAIN OUTCOME MEASURES:Rate of diagnosis, type of mental health visit, type of treatment received (medication or psychotherapy), rate of psychotropic medications prescription, and specialty of the treating physician. RESULTS:From 1993-1996 to 2000-2002, the proportion of office visits in which mental health care was provided decreased for Hispanics from 12.2% to 11.7% while it increased from 13.1% to 15.7% for non-Hispanics (P < 0.05). Visits with a diagnosis of mental disorder decreased from 5.2% to 5.1% in Hispanics but increased from 6.0% to 8.8% in non-Hispanics (P < 0.05). Visits resulting in prescription of a psychotropic medication decreased from 10.2% to 9.3% in Hispanics, while they increased from 10.2% to 12.5% in non-Hispanics (P < 0.05). Psychotherapy visits decreased from 2.4% to 1.3% in Hispanics (P < 0.05), whereas they remained constant (2.5%) in non-Hispanics. Visits to a psychiatrist decreased from 2.5% to 1.3% in Hispanics (P < 0.05), while they increased (nonsignificantly) from 3.1% to 3.5% for non-Hispanics. Most differences persisted after adjusting for age and insurance status. CONCLUSIONS:From 1993 to 2002, there was an increase in mental health care disparities between Hispanics and non-Hispanics treated by office-based physicians. Improvement of the mental health care for Hispanics continues to be an important public health priority, with clear opportunities and challenges for health care policy-makers and practitioners.

journal_name

Med Care

journal_title

Medical care

authors

Blanco C,Patel SR,Liu L,Jiang H,Lewis-Fernández R,Schmidt AB,Liebowitz MR,Olfson M

doi

10.1097/MLR.0b013e3180ca95d3

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

1012-9

issue

11

eissn

0025-7079

issn

1537-1948

pii

00005650-200711000-00002

journal_volume

45

pub_type

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