title: Ethnic differences and similarities in outpatient treatment for depression in the Netherlands.
abstract: OBJECTIVE
  There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands.
  
  
  METHODS
  Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses.
  
  
  RESULTS
  When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch.
  
  
  CONCLUSIONS
  The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded.
authors.affiliation: Amsterdam Municipal Health Service, Nieuwe Achtergracht 100, 1000 CE, Amsterdam, the Netherlands. tfassaert@ggd.amsterdam.nl
authors.forename: Thijs
authors.initials: T
authors.lastname: Fassaert
authors.forename: Jaap
authors.initials: J
authors.lastname: Peen
authors.forename: Annemieke
authors.initials: A
authors.lastname: van Straten
authors.forename: Matty
authors.initials: M
authors.lastname: de Wit
authors.forename: Agnes
authors.initials: A
authors.lastname: Schrier
authors.forename: Henk
authors.initials: H
authors.lastname: Heijnen
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.forename: Arnoud
authors.initials: A
authors.lastname: Verhoeff
authors.forename: Aartjan
authors.initials: A
authors.lastname: Beekman
authors.forename: Jack
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D003863:Depression / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries