Race and gender differences in the treatment of psychiatric disorders in young adolescents.
OBJECTIVE
Most children and adolescents with mental illness remain untreated. Evidence suggests that race is a factor in the referral of children for treatment. This study examines race and gender differences in treatment of adolescent psychiatric disorders.


METHODS
During a two-stage, school-based, epidemiological study of depression, data were collected on 478 adolescents. Instruments included the Schedule for Affective Disorders and Schizophrenia for School-Age Children and the Children's Global Assessment Scale.


RESULTS
Twenty-two percent of the sample had contact with professionals during the prior year, including 56% of adolescents with a psychiatric diagnosis. Significant odds ratios (ORs) were found between all diagnoses and treatment. Trends for undertreatment of females and African-Americans were evident in univariable and multivariable models. The OR (0.34) for African-American females was significant in the multivariable model. African-Americans were significantly more likely to receive only one or two treatment contacts.


CONCLUSIONS
Data suggest race and gender differences in the treatment of adolescent psychiatric disorders. Possible explanations include referral bias, low cultural competence of mental health professionals, and cultural differences in the expression and tolerance of symptoms and help-seeking behaviors. Further study of factors influencing treatment decisions is needed.
William S. Hall Psychiatric Institute, University of South Carolina School of Medicine, Columbia, USA.
S P
SP
Cuffe
J L
JL
Waller
M L
ML
Cuccaro
A J
AJ
Pumariega
C Z
CZ
Garrison
D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D000553:Ambulatory Care; D003431:Cross-Cultural Comparison; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care; D012737:Sex Factors; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology*