Racial and ethnic disparities in detection and treatment of depression and anxiety among psychiatric and primary health care visits, 1995-2005.
BACKGROUND
Recent evidence questions whether formerly documented disparities in care for common mental disorders among African Americans and Hispanics still remain. Also, whether disparities exist mainly in psychiatric settings or primary health care settings is unknown.


OBJECTIVE
To comprehensively examine time trends in outpatient diagnosis and treatment of depression and anxiety among ethnic groups in primary care and psychiatric settings.


METHODS
Analyses of office-based outpatient visits from the National Ambulatory Medical Care Study from 1995-2005 (n = 96,075).


METHODS
Visits to office-based primary care physicians and psychiatrists in the United States.


METHODS
Diagnosed with depression or anxiety, received counseling or a referral for counseling, received an antidepressant prescription, and any counseling or antidepressant care.


RESULTS
In these analyses of 10-year trends in treatment of common mental disorders, disparities in counseling/referrals for counseling, antidepressant medications, and any care vastly improved or were eliminated over time in psychiatric visits. Continued disparities in diagnoses, counseling/referrals for counseling, antidepressant medication, and any care are found in primary care visits.


CONCLUSIONS
Disparities in care for depression and anxiety among African Americans and Hispanics remain in primary care. Quality improvement efforts are needed to address cultural and linguistic barriers to care.
Stockdale
Susan E
SE
UCLA Semel Institute Health Services Research Center; Los Angeles, California 90024, USA. sstockdale@mednet.ucla.edu
Lagomasino
Isabel T
IT
Siddique
Juned
J
McGuire
Thomas
T
Miranda
Jeanne
J
D001741:Black or African American / Q000523:psychology; D001007:Anxiety / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D003863:Depression / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys / Q000379:methods; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D009819:Office Visits / Q000639:trends*; D011320:Primary Health Care; D014481:United States; D044465:White People / Q000523:psychology