title: Ethnic disparities in mental health treatment gap in a community-based survey and in access to care in psychiatric clinics.
abstract: BACKGROUND
  Contrasting social status of ethnic groups differentially impacts the use of psychiatric services, including in Israel, despite its universal health system. However, relevant studies are limited.
  
  
  OBJECTIVE
  To examine ethnic differences in mental health treatment gap and in access to specialized care.
  
  
  METHODS
  Data were gathered from two sources. Study I included Mizrahi (Jews of North African/Asian origin, socially disadvantaged, n = 136) and Ashkenazi (Jews of European American origin, socially advantaged, n = 69) who were diagnosed with common mental disorders in the preceding 12 months in the Israeli component of the World Mental Health Survey. Study II included Mizrahi (n = 133) and Ashkenazi (n = 96) service users entering ambulatory mental health care.
  
  
  RESULTS
  Study I showed that the treatment gap was larger among Mizrahi compared with Ashkenazi respondents (28% standard error (SE) = 4.1 and 45% SE = 6.2, respectively, sought services) following adjustment for sociodemographic confounders (adjusted odds ratio (AOR) = 2.28, 95% confidence interval (CI) = 1.1-4.8). Study II showed that the access to specialized care lagged over a year among 40% of service users of both ethnic groups. No significant ethnic differences emerged in variables related to delay in accessing care.
  
  
  CONCLUSIONS
  Treatment gap was larger among ethnically disadvantaged compared with the advantaged group. However, once in treatment, service users of both ethnic groups report similar barriers to care.
authors.affiliation: School of Psychology, Interdisciplinary Center (IDC) Herzliya, Israel onakash@idc.ac.il.
authors.forename: Ora
authors.initials: O
authors.lastname: Nakash
authors.affiliation: School of Psychology, Interdisciplinary Center (IDC) Herzliya, Israel.
authors.forename: Maayan
authors.initials: M
authors.lastname: Nagar
authors.affiliation: The Jerusalem Mental Health Center, Jerusalem, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Danilovich
authors.affiliation: The Jerusalem Mental Health Center, Jerusalem, Israel.
authors.forename: Daphne
authors.initials: D
authors.lastname: Bentov-Gofrit
authors.affiliation: Outpatient Clinic, Abarbanel Mental Health Center, Bat-Yam, Israel.
authors.forename: Ido
authors.initials: I
authors.lastname: Lurie
authors.affiliation: Hanotrim Mental Health Clinic, Shalvata Mental Health Center, Raanana, Israel.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Steiner
authors.affiliation: Hanotrim Mental Health Clinic, Shalvata Mental Health Center, Raanana, Israel.
authors.forename: Shiri
authors.initials: S
authors.lastname: Sadeh-Sharvit
authors.affiliation: Outpatient Clinic, Abarbanel Mental Health Center, Bat-Yam, Israel.
authors.forename: Henri
authors.initials: H
authors.lastname: Szor
authors.affiliation: Department of Community Mental Health, Faculty of Social Welfare & Health Sciences, Haifa University, Israel.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Levav
mesh_terms: D000328:Adult; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*
keywords: Treatment gap; ethnic differences; mental health; treatment barriers; treatment lag