Mental health service utilization by African Americans and whites: The Baltimore Epidemiologic Catchment Area Follow-Up

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. To compare mental health service utilization and its associated factors between African Americans and whites in the 1980s and 1990s. DESIGN. Household-based longitudinal study with baseline interviews in 1981 and follow-up interviews from 1993 to 1996. SETTING. The Baltimore Epidemiologic Catchment Area (ECA) Follow-Up. SUBJECTS. Subjects included 1,662 adults (590 African Americans and 1,072 whites). MAIN OUTCOME VARIABLE. Use of mental health services, defined as talking to any health professional about emotional or nervous problems or alcohol or drug-related problems within the 6 months preceding each interview. RESULTS. In 1981, crude rates of mental health service use in general medical (GM) settings and specialty mental health settings were similar for African Americans and whites (11.7%). However, after adjustment for predisposing, need, and enabling factors, individuals receiving mental health services were less likely to be African American. Mental health service use increased by 6.5% over follow-up, and African Americans were no longer less likely to report receiving any mental health services in the 1990s. African Americans were more likely than whites to report discussing mental health problems in GM settings without having seen a mental health specialist. They were less likely than whites to report use of specialty mental health services, but this finding was not statistically significant, possibly because of low rates of specialty mental health use by both race groups. Psychiatric distress was the strongest predictor of mental health service use. Attitudes positively associated with use of mental health services were more prevalent among African Americans than whites. CONCLUSIONS. Mental health service use increased in the past decade, with the greatest increase among African Americans in GM settings. Although it is possible that the racial disparity in use of specialty mental health services remains, the GM setting may offer a safety net for some mental health concerns of African Americans.

Original languageEnglish (US)
Pages (from-to)1034-1045
Number of pages12
JournalMedical Care
Volume37
Issue number10
DOIs
StatePublished - 1999

Fingerprint

Baltimore
Mental Health Services
African Americans
health service
utilization
mental health
Mental Health
Interviews
Causality
American
interview
Psychiatry
Longitudinal Studies
Alcohols
Medicine

Keywords

  • African Americans
  • Longitudinal studies
  • Mental health services

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

@article{e69c2c165b074aad87d254a912544a2b,
title = "Mental health service utilization by African Americans and whites: The Baltimore Epidemiologic Catchment Area Follow-Up",
abstract = "OBJECTIVE. To compare mental health service utilization and its associated factors between African Americans and whites in the 1980s and 1990s. DESIGN. Household-based longitudinal study with baseline interviews in 1981 and follow-up interviews from 1993 to 1996. SETTING. The Baltimore Epidemiologic Catchment Area (ECA) Follow-Up. SUBJECTS. Subjects included 1,662 adults (590 African Americans and 1,072 whites). MAIN OUTCOME VARIABLE. Use of mental health services, defined as talking to any health professional about emotional or nervous problems or alcohol or drug-related problems within the 6 months preceding each interview. RESULTS. In 1981, crude rates of mental health service use in general medical (GM) settings and specialty mental health settings were similar for African Americans and whites (11.7{\%}). However, after adjustment for predisposing, need, and enabling factors, individuals receiving mental health services were less likely to be African American. Mental health service use increased by 6.5{\%} over follow-up, and African Americans were no longer less likely to report receiving any mental health services in the 1990s. African Americans were more likely than whites to report discussing mental health problems in GM settings without having seen a mental health specialist. They were less likely than whites to report use of specialty mental health services, but this finding was not statistically significant, possibly because of low rates of specialty mental health use by both race groups. Psychiatric distress was the strongest predictor of mental health service use. Attitudes positively associated with use of mental health services were more prevalent among African Americans than whites. CONCLUSIONS. Mental health service use increased in the past decade, with the greatest increase among African Americans in GM settings. Although it is possible that the racial disparity in use of specialty mental health services remains, the GM setting may offer a safety net for some mental health concerns of African Americans.",
keywords = "African Americans, Longitudinal studies, Mental health services",
author = "Cooper, {Lisa A} and Gallo, {Joseph J} and Powe, {Neil R.} and Steinwachs, {Donald M.} and Eaton, {William W} and Ford, {Daniel E}",
year = "1999",
doi = "10.1097/00005650-199910000-00007",
language = "English (US)",
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pages = "1034--1045",
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TY - JOUR

T1 - Mental health service utilization by African Americans and whites

T2 - The Baltimore Epidemiologic Catchment Area Follow-Up

AU - Cooper, Lisa A

AU - Gallo, Joseph J

AU - Powe, Neil R.

AU - Steinwachs, Donald M.

AU - Eaton, William W

AU - Ford, Daniel E

PY - 1999

Y1 - 1999

N2 - OBJECTIVE. To compare mental health service utilization and its associated factors between African Americans and whites in the 1980s and 1990s. DESIGN. Household-based longitudinal study with baseline interviews in 1981 and follow-up interviews from 1993 to 1996. SETTING. The Baltimore Epidemiologic Catchment Area (ECA) Follow-Up. SUBJECTS. Subjects included 1,662 adults (590 African Americans and 1,072 whites). MAIN OUTCOME VARIABLE. Use of mental health services, defined as talking to any health professional about emotional or nervous problems or alcohol or drug-related problems within the 6 months preceding each interview. RESULTS. In 1981, crude rates of mental health service use in general medical (GM) settings and specialty mental health settings were similar for African Americans and whites (11.7%). However, after adjustment for predisposing, need, and enabling factors, individuals receiving mental health services were less likely to be African American. Mental health service use increased by 6.5% over follow-up, and African Americans were no longer less likely to report receiving any mental health services in the 1990s. African Americans were more likely than whites to report discussing mental health problems in GM settings without having seen a mental health specialist. They were less likely than whites to report use of specialty mental health services, but this finding was not statistically significant, possibly because of low rates of specialty mental health use by both race groups. Psychiatric distress was the strongest predictor of mental health service use. Attitudes positively associated with use of mental health services were more prevalent among African Americans than whites. CONCLUSIONS. Mental health service use increased in the past decade, with the greatest increase among African Americans in GM settings. Although it is possible that the racial disparity in use of specialty mental health services remains, the GM setting may offer a safety net for some mental health concerns of African Americans.

AB - OBJECTIVE. To compare mental health service utilization and its associated factors between African Americans and whites in the 1980s and 1990s. DESIGN. Household-based longitudinal study with baseline interviews in 1981 and follow-up interviews from 1993 to 1996. SETTING. The Baltimore Epidemiologic Catchment Area (ECA) Follow-Up. SUBJECTS. Subjects included 1,662 adults (590 African Americans and 1,072 whites). MAIN OUTCOME VARIABLE. Use of mental health services, defined as talking to any health professional about emotional or nervous problems or alcohol or drug-related problems within the 6 months preceding each interview. RESULTS. In 1981, crude rates of mental health service use in general medical (GM) settings and specialty mental health settings were similar for African Americans and whites (11.7%). However, after adjustment for predisposing, need, and enabling factors, individuals receiving mental health services were less likely to be African American. Mental health service use increased by 6.5% over follow-up, and African Americans were no longer less likely to report receiving any mental health services in the 1990s. African Americans were more likely than whites to report discussing mental health problems in GM settings without having seen a mental health specialist. They were less likely than whites to report use of specialty mental health services, but this finding was not statistically significant, possibly because of low rates of specialty mental health use by both race groups. Psychiatric distress was the strongest predictor of mental health service use. Attitudes positively associated with use of mental health services were more prevalent among African Americans than whites. CONCLUSIONS. Mental health service use increased in the past decade, with the greatest increase among African Americans in GM settings. Although it is possible that the racial disparity in use of specialty mental health services remains, the GM setting may offer a safety net for some mental health concerns of African Americans.

KW - African Americans

KW - Longitudinal studies

KW - Mental health services

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