National trends in ethnic disparities in mental health care.

Carlos Blanco, Sapana R Patel, Linxu Liu, Huiping Jiang, Roberto Lewis-Fernández, Andrew B Schmidt, Michael R Liebowitz, Mark Olfson
Author Information
  1. Carlos Blanco: Departments of Psychiatry, New York State Psychiatric Institute/Columbia University, 1051 Riverside Drive, New York, NY 10032, USA. Cblanco@nyspi.cpmc.columbia.edu

Abstract

OBJECTIVE: To compare trends in office-based treatment of mental disorders between Hispanics and non-Hispanics.
DESIGN, SETTING, AND PARTICIPANTS: Analysis of a nationally representative sample of visits to office-based physicians conducted between 1993 and 2002 (N = 251,905). Visits were grouped into 3 discrete time periods, 1993-1996, 1997-1999 and 2000-2002.
MAIN OUTCOME MEASURES: Rate of diagnosis, type of mental health visit, type of treatment received (medication or psychotherapy), rate of psychotropic medications prescription, and specialty of the treating physician.
RESULTS: From 1993-1996 to 2000-2002, the proportion of office visits in which mental health care was provided decreased for Hispanics from 12.2% to 11.7% while it increased from 13.1% to 15.7% for non-Hispanics (P < 0.05). Visits with a diagnosis of mental disorder decreased from 5.2% to 5.1% in Hispanics but increased from 6.0% to 8.8% in non-Hispanics (P < 0.05). Visits resulting in prescription of a psychotropic medication decreased from 10.2% to 9.3% in Hispanics, while they increased from 10.2% to 12.5% in non-Hispanics (P < 0.05). Psychotherapy visits decreased from 2.4% to 1.3% in Hispanics (P < 0.05), whereas they remained constant (2.5%) in non-Hispanics. Visits to a psychiatrist decreased from 2.5% to 1.3% in Hispanics (P < 0.05), while they increased (nonsignificantly) from 3.1% to 3.5% for non-Hispanics. Most differences persisted after adjusting for age and insurance status.
CONCLUSIONS: From 1993 to 2002, there was an increase in mental health care disparities between Hispanics and non-Hispanics treated by office-based physicians. Improvement of the mental health care for Hispanics continues to be an important public health priority, with clear opportunities and challenges for health care policy-makers and practitioners.

Grants

  1. K23 DA 00482/NIDA NIH HHS

MeSH Term

Adult
Aged
Antipsychotic Agents
Drug Utilization
Female
Health Services Accessibility
Humans
Insurance Coverage
Insurance, Health
Male
Medicine
Mental Disorders
Mental Health Services
Middle Aged
Socioeconomic Factors
Specialization
United States

Chemicals

Antipsychotic Agents

Word Cloud

Created with Highcharts 10.0.0Hispanicsmentalnon-HispanicshealthcaredecreasedP<005Visits2%increased5%office-basedvisits31%3%2trendstreatmentphysicians199320021993-19962000-2002diagnosistypemedicationpsychotropicprescription127%5101disparitiesOBJECTIVE:comparedisordersDESIGNSETTINGANDPARTICIPANTS:AnalysisnationallyrepresentativesampleconductedN=251905groupeddiscretetimeperiods1997-1999MAINOUTCOMEMEASURES:RatevisitreceivedpsychotherapyratemedicationsspecialtytreatingphysicianRESULTS:proportionofficeprovided111315disorder60%88%resulting9Psychotherapy4%whereasremainedconstantpsychiatristnonsignificantlydifferencespersistedadjustingageinsurancestatusCONCLUSIONS:increasetreatedImprovementcontinuesimportantpublicpriorityclearopportunitieschallengespolicy-makerspractitionersNationalethnic

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