Racial/ethnic disparities in service utilization for individuals with co-occurring mental health and substance use disorders in the general population: results from the national epidemiologic survey on alcohol and related conditions.
OBJECTIVE
This study sought to determine whether black/white disparities in service utilization for mental health and substance use disorders persist or are diminished among individuals with psychiatric comorbidity in the general population.


METHODS
The 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions was used to identify individuals with lifetime co-occurring substance use disorders and mood/anxiety disorders (N = 4250; whites, N = 3597; blacks, N = 653). Lifetime service utilization for problems with mood, anxiety, alcohol, and drugs was assessed.


RESULTS
Compared to whites, blacks with co-occurring mood or anxiety and substance use disorders were significantly less likely to receive services for mood or anxiety disorders, equally likely to receive services for alcohol use disorders, and more likely to receive some types of services for drug use disorders. Regardless of race/ethnicity, individuals with these co-occurring disorders were almost twice as likely to use services for mood/anxiety disorders than for substance use disorders.


CONCLUSIONS
Despite the fact that comorbidity generally increases the likelihood of service use, black/white disparities in service utilization among an all-comorbid sample were found, although these disparities differed by type of disorder. Further research is warranted to understand the factors underlying these differences. Prevention and intervention strategies are needed to address the specific mental health needs of blacks with co-occurring disorders, as well as the overall lack of service use for substance use disorders among individuals with co-occurring psychiatric conditions.
Hatzenbuehler
Mark L
ML
Department of Psychology, Yale University, New Haven, Connecticut, USA.
Keyes
Katherine M
KM
Narrow
William E
WE
Grant
Bridget F
BF
Hasin
Deborah S
DS
D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000534:rehabilitation; D000437:Alcoholism / Q000175:diagnosis / Q000208:ethnology* / Q000534:rehabilitation; D001008:Anxiety Disorders / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D044383:Black People / Q000706:statistics & numerical data; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry); D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015995:Prevalence; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000208:ethnology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American