Disparities in Treatment for Substance Use Disorders and Co-Occurring Disorders for Ethnic/Racial Minority Youth

Abstract

Objective To review the literature on racial and ethnic disparities in behavioral health services and present recent data, focusing on services for substance use disorders (SUD) and comorbid mental health disorders for children and adolescents. Method A literature review was conducted of behavioral health services for minority youth. Papers were included if specific comparisons in receipt of SUD services for youth were made by race or ethnicity. The review was organized following the Sociocultural Framework. Results Compared to non-Latino Whites with SUD, Black adolescents with SUD report receiving less specialty and informal care, while Latinos with SUD report less informal services. Potential mechanisms of racial and ethnic disparities were identified in: federal and economic health care policies and regulations; the operation of the health care system and provider organization; provider level factors; the environmental context; the operation of the community system; and patient level factors. Significant disparities reductions could be achieved by adoption of certain state policies and regulations that increase eligibility in public insurance. There is also a need to study how the organization of treatment services might lead to service disparities, particularly problems in treatment completion. Institutional and family characteristics linked to better quality of care should be explored. Since treatments appear to work well independent of race/ethnicity, translational research to bring evidence based care in diverse communities can bolster their effectiveness. Conclusions Our review suggests promising venues to reduce ethnic and racial disparities in behavioral health services for ethnic and racial minority youth.

Peer Network Counseling as Brief Treatment for Urban Adolescent Heavy Cannabis Users

“…Of those who develop cannabis use disorder, African Americans have the highest rates of transition from first use to cannabis disorder compared with other subgroups (Lopez-Quintero et al, 2011). African American youth with substance use disorders are less likely to receive specialty care compared with their White and Hispanic counterparts (Alegria et al, 2011). Even when they do engage in treatment, African American youth receive significantly fewer treatment sessions than their White peers (Becker et al, 2012), are more likely to leave treatment prematurely (Austin & Wagner, 2010), and are less likely to complete posttreatment assessment (Becker et al, 2012).…”

Engagement and Retention of Ethnically Diverse Adolescents to a Voluntary, School-Based Alcohol Use Intervention

“…11 Given the disparities in service utilization among ethnic minority teens, school-based BIs have the potential of reaching youth who might not typically receive services. 6, 12 Importantly, the school setting also represents a key social context for adolescents. Teens spend a large majority of their time in school with their peers, who have increased influence during this developmental period.…”

Association of exposure to neighborhood drug activity, neurobehavioral traits, and marijuana use among at-risk African American females

“…Our focus on African Americans is critical given that this group is exposed to multiple and unique risk factors (Chen & Jacobson, 2012;Finlay, White, Mun, Cronley, & Lee, 2012;Saxe et al, 2001;Wu, Temple, Shokar, Nguyen-Oghalai, & Grady, 2010), is among those least likely to receive treatment for substance use disorders (Alegria, Carson, Goncalves, & Keefe, 2011;Wells, Klap, Koike, & Sherbourne, 2001), and suffers the highest rates of morbidities associated with drug use (Gil, Wagner, & Tubman, 2004;Green et al, 2010;Zapolski et al, 2014). Moreover, while comparing disadvantaged females to females from higher SES and African Americans to Whites is useful, these approaches provide limited information for designing tailored interventions.…”