Anika L Hines1, Lisa A Cooper2, Leiyu Shi3. 1. Johns Hopkins School of Medicine, 2024 E. Monument Street, Suite 2-516b, Baltimore, MD 21287, United States. Electronic address: anika.hines@jhmi.edu. 2. Johns Hopkins School of Medicine, 2024 E. Monument Street, Suite 2-500, Baltimore, MD 21287, United States. 3. Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States.
Abstract
OBJECTIVE: Ethnic minorities are less likely than Whites to initiate and continue mental healthcare. Minorities also prefer non-medical approaches to address mental health issues. We evaluated sector-type as a modifier of the association of race/ethnicity with service utilization for mental health. We hypothesized that minorities utilize non-mental health sectors at rates consistent with guidelines and similar to Whites. METHODS: We examined data from the Collaborative Psychiatric Epidemiologic Studies (CPES) (n=3803). We used logistic regression to assess the association of race/ethnicity with utilization consistent with potentially effective care across sectors-psychiatry, medical, non-medical mental health, human services, and spiritual. RESULTS: Asians [OR: 0.56 CI: 0.39, 0.82] and Blacks [OR: 0.74 CI: 0.60, 0.92] had lower odds of having ≥1 visit compared to Whites. Blacks also had lower odds of ≥4 [OR: 0.66 CI: 0.50, 0.87] and ≥12 visits [OR: 0.58 CI: 0.41, 0.83]. Sector-type modified these associations. Compared to Whites, Asians [OR: 0.49 CI: 0.30, 0.82] and Blacks [OR: 0.71 CI: 0.54, 0.94] had lower odds of ≥1 visit to the medical sector. Asians had lower odds of seeing psychiatrists for ≥8 visits [OR: 0.15 CI: 0.04, 0.54] and ≥12 visits [OR: 0.21 CI: 0.06, 0.77]. Asians and Blacks demonstrated similar utilization to Whites in non-medical mental health and spiritual settings. CONCLUSION: Racial/ethnic differences in utilization consistent with treatment guidelines are ameliorated in sectors preferred by minorities.
OBJECTIVE: Ethnic minorities are less likely than Whites to initiate and continue mental healthcare. Minorities also prefer non-medical approaches to address mental health issues. We evaluated sector-type as a modifier of the association of race/ethnicity with service utilization for mental health. We hypothesized that minorities utilize non-mental health sectors at rates consistent with guidelines and similar to Whites. METHODS: We examined data from the Collaborative Psychiatric Epidemiologic Studies (CPES) (n=3803). We used logistic regression to assess the association of race/ethnicity with utilization consistent with potentially effective care across sectors-psychiatry, medical, non-medical mental health, human services, and spiritual. RESULTS: Asians [OR: 0.56 CI: 0.39, 0.82] and Blacks [OR: 0.74 CI: 0.60, 0.92] had lower odds of having ≥1 visit compared to Whites. Blacks also had lower odds of ≥4 [OR: 0.66 CI: 0.50, 0.87] and ≥12 visits [OR: 0.58 CI: 0.41, 0.83]. Sector-type modified these associations. Compared to Whites, Asians [OR: 0.49 CI: 0.30, 0.82] and Blacks [OR: 0.71 CI: 0.54, 0.94] had lower odds of ≥1 visit to the medical sector. Asians had lower odds of seeing psychiatrists for ≥8 visits [OR: 0.15 CI: 0.04, 0.54] and ≥12 visits [OR: 0.21 CI: 0.06, 0.77]. Asians and Blacks demonstrated similar utilization to Whites in non-medical mental health and spiritual settings. CONCLUSION: Racial/ethnic differences in utilization consistent with treatment guidelines are ameliorated in sectors preferred by minorities.
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