title: Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults.
abstract: This study examines depressed adults' use of mental health services, focusing on Latinos and African Americans. Self-report data for adults meeting CIDI criteria for major depression or dysthymia from the 1997-98 HealthCare for Communities Survey were analyzed. Gender stratified logistic regression models examined the relationship between race/ethnicity and outpatient mental health service use, controlling for sociodemographic, health status, insurance, and geographic characteristics. Latinas and African American women and men exhibited low use of outpatient mental health services. Similar results were observed in an insured subsample. Service use by minorities was more affected by financial and social barriers (e.g., stigma). No gender differences were observed in self-reported barriers to care. Concerted and continued efforts to promote access to mental health services are critical for minority men and women affected by depression; adults may have unmet mental health needs. Other vulnerable populations include older adults especially, men, and men in poor health.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA, 02115, USA. ojeda@hcp.med.harvard.edu
authors.forename: Victoria D
authors.initials: VD
authors.lastname: Ojeda
authors.forename: Thomas G
authors.initials: TG
authors.lastname: McGuire
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D003710:Demography; D003865:Major Depressive Disorder / Q000208:ethnology* / Q000628:therapy; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D019966:Substance-Related Disorders / Q000208:ethnology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology