title: Disparities in Treatment and Service Utilization Among Hispanics and Non-Hispanic Whites with Bipolar Disorder.
abstract: Due to the serious and recurrent nature of bipolar disorder, continuous long-term medication treatment is typically recommended. Little is known about whether these treatment recommendations are effectively implemented for Hispanics. This study examined differences in mood stabilizer use and mental health service utilization between adult English-speaking Hispanic and non-Hispanic white respondents with bipolar disorder.
  
  
  
  The sample included 163 participants with lifetime bipolar I and II disorders in the National Comorbidity Survey Replication. Demographics, symptom presentation, and acculturation were examined as covariates.
  
  
  
  None of the 26 Hispanic respondents were taking mood-stabilizing medication, compared to 21 % of non-Hispanic whites, and Hispanics were less likely to receive medications for emotional problems, see a professional for manic episodes, or attend psychotherapy. Even after accounting for differences in symptom profiles and sociodemographics, ethnicity continued to be a significant predictor of mood stabilizer use and psychotherapy attendance. There was a non-significant trend toward lower acculturation among Hispanics being associated with even poorer service utilization.
  
  
  
  No Hispanics were receiving minimally adequate treatment for their bipolar disorder. Future research should focus on identifying the barriers that lead to these stark ethnic disparities in treatment.
authors.affiliation: The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Salcedo
authors.affiliation: University of California, Berkeley, 3210 Tolman Hall, UC Berkeley, Berkeley, CA, 94720, USA.
authors.forename: Kaja J
authors.initials: KJ
authors.lastname: McMaster
authors.affiliation: University of California, Berkeley, 3210 Tolman Hall, UC Berkeley, Berkeley, CA, 94720, USA. sljohnson@berkeley.edu.
authors.forename: Sheri L
authors.initials: SL
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Acculturation; Bipolar disorder; Latinos/Hispanics; Mood stabilizer use; Service utilization