Ethnicity and mental health treatment utilization by patients with personality disorders.
The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic but not White participants, underscoring the importance of special attention to the treatment relationship with minority patients. These treatment use differences raise complex questions about treatment assessment and delivery, cultural biases of the current diagnostic system, and possible variation in PD manifestation across racial/ethnic groups. Future studies need to assess specific barriers to adequate and appropriate treatments for minority individuals with PDs.
Bender
Donna S
DS
Institute for Mental Health Research, USA. benderd@email.arizona.edu
Skodol
Andrew E
AE
Dyck
Ingrid R
IR
Markowitz
John C
JC
Shea
M Tracie
MT
Yen
Shirley
S
Sanislow
Charles A
CA
Pinto
Anthony
A
Zanarini
Mary C
MC
McGlashan
Thomas H
TH
Gunderson
John G
JG
Daversa
Maria T
MT
Grilo
Carlos M
CM
D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000145:classification / Q000523:psychology* / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000208:ethnology* / Q000628:therapy*; D015995:Prevalence; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data