Disparity in depression treatment among racial and ethnic minority populations in the United States.
OBJECTIVE
Prior research on racial and ethnic disparities in depression treatment has been limited by the scarcity of national samples that include an array of diagnostic and quality indicators and substantial numbers of non-English-speaking individuals from minority groups. Using nationally representative data for 8,762 persons, the authors evaluated differences in access to and quality of depression treatments between patients in racial-ethnic minority groups and non-Latino white patients.


METHODS
Access to mental health care was assessed by past-year receipt of any mental health treatment. Adequate treatment for acute depression was defined as four or more specialty or general health provider visits in the past year plus antidepressant use for 30 days or more or eight or more specialty mental health provider visits lasting at least 30 minutes, with no antidepressant use.


RESULTS
For persons with past-year depressive disorder, 63.7% of Latinos, 68.7% of Asians, and 58.8% of African Americans, compared with 40.2% of non-Latino whites, did not access any past-year mental health treatment (significantly different at p<.001). Disparities in the likelihood of both having access to and receiving adequate care for depression were significantly different for Asians and African Americans in contrast to non-Latino whites.


CONCLUSIONS
Simply relying on present health care systems without consideration of the unique barriers to quality care that ethnic and racial minority populations face is unlikely to affect the pattern of disparities observed. Populations reluctant to visit a clinic for depression care may have correctly anticipated the limited quality of usual care.
Alegría
Margarita
M
Center for Multicultural Mental Health Research, Cambridge Health Alliance and Harvard Medical School, Somerville, MA 02143, USA. malegria@charesearch.org
Chatterji
Pinka
P
Wells
Kenneth
K
Cao
Zhun
Z
Chen
Chih-nan
CN
Takeuchi
David
D
Jackson
James
J
Meng
Xiao-Li
XL
D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000188:drug therapy*; D005006:Ethnicity; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D044469:Racial Groups; D014481:United States; D055815:Young Adult