TY - JOUR
T1 - Racial and ethnic differences in mental healthcare utilization consistent with potentially effective care
T2 - The role of patient preferences
AU - Hines, Anika L.
AU - Cooper, Lisa A
AU - Shi, Leiyu
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Objective Ethnic minorities are less likely than Whites to initiate and continue mental healthcare. Minorities also prefer non-medical approaches to address mental health issues. We evaluated sector-type as a modifier of the association of race/ethnicity with service utilization for mental health. We hypothesized that minorities utilize non-mental health sectors at rates consistent with guidelines and similar to Whites. Methods We examined data from the Collaborative Psychiatric Epidemiologic Studies (CPES) (n = 3803). We used logistic regression to assess the association of race/ethnicity with utilization consistent with potentially effective care across sectors—psychiatry, medical, non-medical mental health, human services, and spiritual. Results Asians [OR: 0.56 CI: 0.39, 0.82] and Blacks [OR: 0.74 CI: 0.60, 0.92] had lower odds of having ≥ 1 visit compared to Whites. Blacks also had lower odds of ≥ 4 [OR: 0.66 CI: 0.50, 0.87] and ≥ 12 visits [OR: 0.58 CI: 0.41, 0.83]. Sector-type modified these associations. Compared to Whites, Asians [OR: 0.49 CI: 0.30, 0.82] and Blacks [OR: 0.71 CI: 0.54, 0.94] had lower odds of ≥ 1 visit to the medical sector. Asians had lower odds of seeing psychiatrists for ≥ 8 visits [OR: 0.15 CI: 0.04, 0.54] and ≥ 12 visits [OR: 0.21 CI: 0.06, 0.77]. Asians and Blacks demonstrated similar utilization to Whites in non-medical mental health and spiritual settings. Conclusion Racial/ethnic differences in utilization consistent with treatment guidelines are ameliorated in sectors preferred by minorities.
AB - Objective Ethnic minorities are less likely than Whites to initiate and continue mental healthcare. Minorities also prefer non-medical approaches to address mental health issues. We evaluated sector-type as a modifier of the association of race/ethnicity with service utilization for mental health. We hypothesized that minorities utilize non-mental health sectors at rates consistent with guidelines and similar to Whites. Methods We examined data from the Collaborative Psychiatric Epidemiologic Studies (CPES) (n = 3803). We used logistic regression to assess the association of race/ethnicity with utilization consistent with potentially effective care across sectors—psychiatry, medical, non-medical mental health, human services, and spiritual. Results Asians [OR: 0.56 CI: 0.39, 0.82] and Blacks [OR: 0.74 CI: 0.60, 0.92] had lower odds of having ≥ 1 visit compared to Whites. Blacks also had lower odds of ≥ 4 [OR: 0.66 CI: 0.50, 0.87] and ≥ 12 visits [OR: 0.58 CI: 0.41, 0.83]. Sector-type modified these associations. Compared to Whites, Asians [OR: 0.49 CI: 0.30, 0.82] and Blacks [OR: 0.71 CI: 0.54, 0.94] had lower odds of ≥ 1 visit to the medical sector. Asians had lower odds of seeing psychiatrists for ≥ 8 visits [OR: 0.15 CI: 0.04, 0.54] and ≥ 12 visits [OR: 0.21 CI: 0.06, 0.77]. Asians and Blacks demonstrated similar utilization to Whites in non-medical mental health and spiritual settings. Conclusion Racial/ethnic differences in utilization consistent with treatment guidelines are ameliorated in sectors preferred by minorities.
KW - Depression
KW - Disparities
KW - Patient-centered care
KW - Race/ethnicity
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U2 - 10.1016/j.genhosppsych.2017.02.002
DO - 10.1016/j.genhosppsych.2017.02.002
M3 - Article
C2 - 28622809
AN - SCOPUS:85013254087
SN - 0163-8343
VL - 46
SP - 14
EP - 19
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
ER -