Racial and ethnic differences in mental healthcare utilization consistent with potentially effective care: The role of patient preferences

Hines, Anika L; Cooper, Lisa A.; Shi, Leiyu

doi:10.1016/j.genhosppsych.2017.02.002

Cited by 33 publications

(28 citation statements)

References 22 publications

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“…One study in particular found that household income and unemployment predicted greater odds of major depressive episodes among African Americans and an inverse relationship between education level and a 12-month major depressive episode. Additionally, an inverse relationship between income and 12-month major depressive episode (MDE) was noted in African American, particularly in women 5. In addition to socioeconomic factors, home environment was also assessed for risk of depression in African Americans.…”

Section: Introductionmentioning

confidence: 99%

<p>Racial and ethnic differences in depression: current perspectives</p>

Bailey¹,

Mokonogho²,

Kumar³

2019

NDT

318

161

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Major depressive disorder (MDD) is among the most prevalent disorders in the US that often goes underdiagnosed and untreated. The burden of disability among those untreated is heaviest among untreated minority populations. Recent studies show that among African Americans, those with socioeconomic stress are less likely to report psychological symptoms or remain compliant with initiated treatment. While minority populations are less likely to suffer from acute episodes of MDD than Caucasians, they are more likely to suffer from prolonged, chronic, and severely debilitating depression with heavy consequences on their level of daily functioning. Part of the problem of underdiagnoses lies with the provider. Many providers today are unable to notice subtleties in presentation or recognize uncommon presentation of disease. This paper focuses on discrepancies in the presentation of depression among minorities when compared to Caucasians as well as factors that serve as boundaries for successful treatment.

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Section: Introductionmentioning

confidence: 99%

<p>Racial and ethnic differences in depression: current perspectives</p>

Bailey¹,

Mokonogho²,

Kumar³

2019

NDT

318

161

View full text Add to dashboard Cite

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“…Clarifying precisely the nature of these disparities in treatment use is a necessary step toward addressing suicidality across racial/ethnic minority populations. Specifically, although several prior studies have investigated mental health treatment rates for suicidality across racial/ethnic categories (Chakravarthy et al, 2014; Han et al, 2014; Hines et al, 2017), more fine-grained examinations of severity of suicidality in relation to level of clinical care are necessary for their potential to inform mental health treatment. Intensity of clinical care was determined as receipt of either inpatient treatment services, implying need for acute level of care and temporary admission to a hospital setting, with patients expressing imminent safety concerns for suicidal behaviors compared to outpatient treatment service outside of the hospital setting, utilized by patients at a high risk for suicidal behaviors, albeit presenting a lower immediate threat to their safety.…”

Section: Introductionmentioning

confidence: 99%

Racial and ethnic differences in mental health service utilization in suicidal adults: A nationally representative study

Sheehan

Walsh

Liu

2018

Journal of Psychiatric Research

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The current study examined racial/ethnic differences in utilization of mental health services in a nationally representative sample of suicidal adults. Data were extracted from the National Survey on Drug Use and Health (NSDUH) from 2009 to 2016. Participants consisted of adults with severe suicidal ideation and/or behavior in the past 12 months (unweighted n = 17,338). Multivariate logistic regression analyses were conducted to assess racial/ethnic differences in mental health treatment utilization after adjusting for health insurance status, family income, age, sex, and major depression. Analyses were conducted separately for suicidal ideators with no attempts (i. e., “pure” ideators; unweighted n = 14,578) and for suicide attempters (unweighted n = 2,760) for psychiatric inpatient and outpatient care, respectively. Racial/ethnic disparities in mental health treatment utilization were less apparent for inpatient care and most evident for outpatient care. For inpatient care, no racial/ethnic differences were observed among suicidal ideators with no attempts. Among suicide attempters, only Hispanics were less likely than non-Hispanic whites to receive inpatient care. In contrast, for outpatient care, treatment use was lower for all racial ethnic minorities, except Native American and multiracial individuals, relative to non-Hispanic whites among suicidal ideators with no attempts. Outpatient service use was also lower for non-Hispanic blacks, Hispanics, and multiracial individuals relative to non-Hispanic whites among suicide attempters. This pattern of findings is consistent with the possibility that suicidal racial/ethnic minorities may delay use of mental health services until clinical severity becomes such that elevated clinical care (i.e., inpatient treatment) is required. Future research accounting for these disparities is warranted.

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“…These gender and racial/ethnic differences are roughly concordant with US demographic patterns in depression prevalence observed beyond the ED setting [13]. However, these patterns have been problematized by research indicating that certain non-White minority populations are less likely to receive or seek mental health diagnoses and care [14][15][16]. If the large proportion of Whites among patients with depression partly reflects such differences in diagnosis and treatment seeking, there may in fact be a number of non-White patients with unaddressed mental health care needs in the ED.…”

Section: Resultsmentioning

confidence: 70%

Analysis of Emergency Department Visits for All Reasons by Adults with Depression in the United States

Hill

Jiang

Friese

et al. 2020

Preprint

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Background : We aimed to characterize Emergency Department (ED) utilization and outcomes of patients with depression seeking emergency care for all reasons. Methods : Using 2014–2016 ED data from the National Hospital Ambulatory Medical Care Survey, we investigated demographics, ED resource utilization, clinical characteristics, and disposition of patients with depression versus those without depression. Results : Approximately 10,626,184 (11.4%) out of 92,899,685 annual ED visits were by patients with depression. ED patients with depression were mostly non-Hispanic White (74.0%) and were less likely to be male than patients without depression (aOR: 0.56; [95%] CI: 0.56–0.56). ED patients with depression were more likely to be admitted to the hospital (aOR: 1.56; CI: 1.55–1.56) and intensive care unit (ICU) (aOR: 1.28; CI: 1.27–1.28) than patients without depression. Among ED patients with depression, males were more likely than females to be seeking emergency care for psychiatric reasons (aOR: 2.04; CI: 2.03–2.05) and to present with overdose/poisoning (aOR: 1.35; CI: 1.34–1.36). Conclusions : We described the unique demographic, socioeconomic, and clinical characteristics of ED patients with depression, using the most comprehensive, nationally representative study to date. We revealed notable gender disparities in rates and reasons for admissions. The higher hospital and ICU admission rates of ED patients with depression suggests this population requires a higher level of emergency care, for reasons that remain poorly understood.

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Racial and ethnic differences in mental healthcare utilization consistent with potentially effective care: The role of patient preferences

Cited by 33 publications

References 22 publications

<p>Racial and ethnic differences in depression: current perspectives</p>

<p>Racial and ethnic differences in depression: current perspectives</p>

Racial and ethnic differences in mental health service utilization in suicidal adults: A nationally representative study

Analysis of Emergency Department Visits for All Reasons by Adults with Depression in the United States

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