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

Abstract

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.

Suicidal Presentations to Emergency Departments in a Large Australian Public Health Service over 10 Years

“…Despite the previously argued reluctance by many Indigenous Australians to engage with Western-based medical models of treatment [ 48 ], their rates of suicidal presentations to our EDs remained much higher than those of non-Indigenous persons. It is possible that among presentations by Indigenous persons included in our analysis, a greater proportion resulted from suicide attempts, particularly if using methods that are more likely to require medical interventions [ 14 ] or were involuntary in nature [ 49 ].…”

“…Presentations with suicidal ideation have a higher rate of re-presentations than suicide attempts [ 11 ] and are more frequent among males than females [ 11 , 12 ]. Racial and ethnic differences have also been found to impact on rates of suicidal presentations to EDs, with evidence of members of ethnic minority groups displaying a higher risk of suicide yet being less likely to engage with mental health services [ 13 , 14 ].…”

Factors influencing decline in quality of life in smokers without airflow obstruction: The COPDGene study

“…Specifically, black participants had a 4.2 higher adjusted SGRQ score for a hospitalized exacerbation compared to white participants [21]. Black participants may also experience racial discrimination as well as have differences in health behaviors including delays in seeking mental health treatment that may affect quality of life [22,23]. Exacerbation status is reflective of only two points in time; therefore we also performed multivariable logistic regression models for QoL decline with yearly exacerbation frequency as the predictor of interest.…”

A Critical Policy Analysis of Medicare Parts B and D: a Focus on Latin/x and African American Older Adult Mental Health

“…Research has found that across all older adults in need of mental health treatment, Black participants are less likely to receive culturally effective care (Jimenez et al 2012). Similarly, among persons experiencing a mental health crisis, service utilization was lowest among non-Hispanic Blacks, Hispanics, and multiracial individuals (Sheehan et al 2018). The following section describes the actual impact of Medicare Parts B and D on African American and Latin/x older adults with a specific focus on the challenges of this policy and subsequent programming.…”