Latinos with obsessive-compulsive disorder: Mental healthcare utilization and inclusion in clinical trials

Abstract

Previous research has documented that ethnic minorities, particularly Latinos, obtain fewer mental health services than Caucasians (Kearney, Draper, & Baron 2005; Sue, Fujino, Hu, Takeuchi, & Zane, 1991). Conceivably, this may be due to a wide array of cultural issues (e.g., negative stigma attached to mental health, and language, socio-economic, and acculturation barriers), symptom disparities across Caucasian and Latino groups, or lack of effective outreach methods by clinicians and researchers. However, research is limited. As a result, Latinos may be insufficiently represented in clinical studies for OCD, making it unclear whether evidence-based treatments demonstrate the same efficacy and effectiveness for Latinos as has been demonstrated for Caucasians. The current study takes an in-depth analysis of 98 efficacy and effectiveness studies for OCD from across the Western hemisphere and reports the rates of Latino inclusion from each sample. Ninety clinical studies in the US and Canada, as well as eight clinical studies in Mexico and Central America were reviewed. Findings showed that only 11 (24%) US and Canadian studies included Latino participants, illustrating an overwhelming underrepresentation of Latinos in clinical studies for OCD. Further explanation of the results and their implications are discussed, along with suggestions for effectively improving access to mental health research and appropriate treatments.

Overcoming barriers to recruiting ethnic minorities to mental health research: a typology of recruitment strategies

“…A systematic review of all published randomised controlled trials in panic disorder showed that only 44.7% reported ethnicity data for their included sample [ 5 ]. Only 24% of US and Canadian studies have included Latino participants [ 6 ], demonstrating a substantial underrepresentation of Latinos in clinical studies for OCD [ 7 ]. Difficulties with recruiting research participants from ethnic minority groups is not solely restricted to mental health research; such problems have been encountered in range of other areas including research in nursing [ 8 ], public health [ 9 ] and cardiovascular disease [ 10 ].…”

Cultural competency in the treatment of obsessive-compulsive disorder: practitioner guidelines

“…Elders are highly respected and honoured by all Asian cultures, and in many cultural groups, parents or grandparents will have the last word on whether treatment is permitted. Due to the low participation of POC in OCD research, representative information on the efficacy of family-based treatment is limited (Wetterneck et al, 2012). In India, Mehta (1990) demonstrated that a family-based intervention consisting of directed family member supervision, responsibility and support of recovery resulted in significantly greater improvement of OCD symptoms.…”

“…In India, Mehta (1990) demonstrated that a family-based intervention consisting of directed family member supervision, responsibility and support of recovery resulted in significantly greater improvement of OCD symptoms. The importance of social support from family members for communities of colour suggests that group or family-based therapy may be promising options for OCD treatment (Wetterneck et al, 2012). The existence of extended family structures for such clients also communicates that clinicians' integration and championing of family support in psychotherapy would prove beneficial (Ruggles, 1994;Williams et al, 2017c).…”

African Americans with Obsessive-Compulsive Disorder: An Update

“…Considerable progress has been made in understanding, diagnosing, and treating obsessive-compulsive disorder (OCD), but not all groups have been helped by these advances, resulting in a notable mental health disparity. OCD in ethnic minority groups has been -and continues to be -a neglected area of scientific inquiry [2,3].…”

“…Researchers were newly required to include methods through which they would achieve diverse samples in their proposal strategies. Nonetheless, our own comprehensive review of the literature found widespread and ongoing exclusion of various racial and ethnic minority groups [2,3]. Among almost all major OCD clinical trials conducted in North America, ethnic minorities were either underrepresented or their participation was not reported.…”