title: Perceived Discrimination in Health Care and Mental Health/Substance Abuse Treatment Among Blacks, Latinos, and Whites.
abstract: BACKGROUND
  Experiences of discrimination in health care settings may contribute to disparities in mental health outcomes for blacks and Latinos. We investigate whether perceived discrimination in mental health/substance abuse visits contributes to participants' ratings of treatment helpfulness and stopped treatment.
  
  
  METHODS
  We used data from 3 waves of the California Quality of Life Survey, a statewide population-based telephone survey assessing mental health/substance disorders and their treatment. In a sample of 1099 adults (age 18-72) who indicated prior year mental health/substance abuse visits, we examined: experiences of discrimination that occurred during health care and mental health/substance abuse visits, ratings of treatment helpfulness, and reports of stopping treatment early.
  
  
  RESULTS
  Fifteen percent of California adults reported discrimination during a health care visit and 4% specifically during mental health/substance abuse visits. Latinos, the uninsured, and those with past year mental disorders were twice as likely as others to report health care discrimination [adjusted odds ratio (AORs)=2.08, 2.77, and 2.51]. Uninsured patients were 7 times more likely to report discrimination in mental health/substance abuse visits (AOR=7.27, P<0.01). The most commonly reported reasons for health care discrimination were race/ethnicity for blacks (52%) and Latinos (31%), and insurance status for whites (40%). Experiences of discrimination in mental health/substance abuse visits were associated with less helpful treatment ratings for Latinos (AOR=0.09, P<0.05) and whites (AOR=0.25, P<0.01), and early treatment termination for blacks (AOR=13.38, P<0.05).
  
  
  CONCLUSIONS
  Experiences of discrimination are associated with negative mental health/substance abuse treatment experiences and stopped treatment, and could be a factor in mental health outcomes.
authors.affiliation: *Department of Health Policy and Management, UCLA Fielding School of Public Health †UCLA Center for Bridging Research, Innovation, Training and Education for Minority Health Disparities Solutions, Los Angeles, CA ‡Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA §Vera Institute of Justice, New York, NY.
authors.forename: Vickie M
authors.initials: VM
authors.lastname: Mays
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Jones
authors.forename: Ayesha
authors.initials: A
authors.lastname: Delany-Brumsey
authors.forename: Courtney
authors.initials: C
authors.lastname: Coles
authors.forename: Susan D
authors.initials: SD
authors.lastname: Cochran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People / Q000523:psychology; D002140:California; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D010465:Perception; D044469:Racial Groups / Q000523:psychology*; D063505:Racism / Q000523:psychology*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000208:ethnology / Q000628:therapy; D044465:White People / Q000523:psychology; D055815:Young Adult; D001741:Black or African American