Washington, D.C. — According to a new study in theJournal of the American Academy of Child and Adolescent Psychiatry (JAACAP), racial and ethnic minority adolescents are much less likely to receive treatment for major depression. Researchers from the Rollins School of Public Health at Emory in Atlanta analyzed five years of data (2004-2008) collected from the National Survey of Drug Use and Health (NSDUH). Their study evaluated a national representative sample of 7,704 adolescents, from 12 to 17 years of age, who were diagnosed with major depression within the past year. Researchers studied the differences in treatment for depression across four racial/ethnic groups of adolescents with major depression (i.e., non-Hispanic whites, blacks, Hispanics, and Asians). After adjusting for demographics and health status, the percentage of non-Hispanic whites who received any major depression treatment was found to be 40 percent—compared with 32 percent in blacks, 31 percent in Hispanics, and 19 percent in Asians. Black, Hispanic, and Asian adolescents were also significantly less likely than non-Hispanic whites to receive treatment for major depression from mental health professionals, to receive treatment for major depression from medical providers, and to have any mental health outpatient visits, with Asians exhibiting the lowest rate of service use on each measurement.
The NSDUH samples non-institutionalized individuals 12 years and older from all 50 states and the District of Columbia. The survey is conducted annually, in both English and Spanish, and is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Findings were reported in an article titled "Racial/Ethnic Differences in Mental Health Service Use Among Adolescents With Major Depression," by Dr. Janet R. Cummings and Dr. Benjamin G. Druss.
The adjustment for socioeconomic status and health insurance status accounted for only a small portion of the estimated differences in major depression treatment measurements and outpatient utilization across racial/ethnic groups. Other factors, such as stigma and limited proficiency in English, possibly contributed to the lower rates of service use in Hispanics and Asians.
Notably, one fourth of all adolescents with major depression received school-based counseling.
"Investment in quality improvement programs implemented in primary care settings as well as school-based mental health services may reduce unmet need for mental health services in all adolescents with major depression and reduce the sizeable differences in service use across racial/ethnic groups," according to Dr. Cummings and Dr. Druss.
Furthermore the researchers report, "Unlike treatment in outpatient settings, we did not find any significant racial/ethnic differences in the receipt of inpatient treatment."
In a related editorial Dr. Nicholas J. Carson states, "Given the serious consequences of depression, which are not limited to suicide, substance abuse, and academic failure, these low rates are tragic. Future research will also need to clarify how a disproportionately low supply of mental health providers in minority communities affects disparities in access to services."
The study findings reported by Dr. Cummings and Dr. Druss were supported by a National Institute of Mental Health grant and published in the Journal of the American Academy of Child and Adolescent Psychiatry and online at www.jaacap.org.
1. Cummings JR, Druss BG. Racial/Ethnic Differences in Mental Health Service Use Among Adolescents With Major Depression. Journal of the American Academy of Child and Adolescent Psychiatry; 2011; 50:160-170.
2. Carson NJ. The Devil You Know: Revealing Racial/Ethnic Disparities in the Treatment of Adolescent Depression. Journal of the American Academy of Child and Adolescent Psychiatry; 2011; 50:106-107.
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