title: Racial/ethnic differences in perceived reasons for mental health treatment in US adolescents with major depression.
abstract: OBJECTIVE
  Racial/ethnic differences in the course of treatment for a major depressive episode (MDE) among adolescents may arise, in part, from variation in the perceived rationale for treatment. We examined racial/ethnic differences in the perceived reasons for receiving mental health (MH) treatment among adolescents with an MDE.
  
  
  METHODS
  A total of 2,789 adolescent participants who experienced an MDE and received MH treatment in the past year were drawn from the 2005 to 2008 National Survey on Drug Use and Health. Adolescents reported the settings in which they received care and reasons for their most recent visit to each setting. Distributions of specific depressive symptoms were compared across racial/ethnic groups. Racial/ethnic differences in endorsing each of 11 possible reasons for receiving treatment were examined using weighted probit regressions adjusted for sociodemographic characteristics, health and mental health status, treatment setting, and survey year.
  
  
  RESULTS
  Despite similar depressive symptom profiles, Hispanic adolescents were more likely than whites to endorse "breaking rules" or getting into physical fights as reasons for MH treatment. Black adolescents were more likely than white adolescents to endorse "problems at school" but less likely to endorse "felt very afraid or tense" or "eating problems" as reasons for treatment. Asian adolescents were more likely to endorse "problems with people other than friends or family" but less likely than whites to endorse "suicidal thoughts/attempt" and "felt depressed" as reasons for treatment.
  
  
  CONCLUSIONS
  Racial/ethnic minority participants were more likely than white participants to endorse externalizing or interpersonal problems and less likely to endorse internalizing problems as reasons for MH treatment. Understanding racial/ethnic differences in the patient's perceived treatment rationale can offer opportunities to enhance outcomes for depression among diverse populations.
authors.affiliation: Rollins School of Public Health, Emory University. Electronic address: jrcummi@emory.edu.
authors.forename: Janet R
authors.initials: JR
authors.lastname: Cummings
authors.affiliation: Health Services Research Program, Bradley Hospital, Alpert Medical School of Brown University, and Brown Public Health Program.
authors.forename: Brady G
authors.initials: BG
authors.lastname: Case
authors.affiliation: Rollins School of Public Health, Emory University.
authors.forename: Xu
authors.initials: X
authors.lastname: Ji
authors.affiliation: University of Maryland, School of Public Health.
authors.forename: David H
authors.initials: DH
authors.lastname: Chae
authors.affiliation: Rollins School of Public Health, Emory University.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Druss
mesh_terms: D000293:Adolescent; D001526:Behavioral Symptoms / Q000208:ethnology* / Q000628:therapy*; D003865:Major Depressive Disorder / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D014481:United States / Q000208:ethnology
keywords: depression; mental health services; perceived treatment rationale; race/ethnicity