Do Racial and Ethnic Disparities in Mental Health Treatment Vary With Underlying Mental Health?

A long line of studies document substantial and persistent racial and ethnic disparities in the use of mental health services. Many recent studies follow the Institute of Medicine's definition of disparities, adjusting only for differences in health and mental health status across groups. However, controlling for mental health may mask important changes in the magnitudes of disparities at different levels of mental health need. We extend the previous literature by explicitly estimating how differences in treatment use across groups change at different levels of psychological distress. We used detailed data on sociodemographic characteristics, health insurance coverage, treatment, and the K6 psychological distress scale from the 2010 to 2015 Medical Expenditure Panel Survey to estimate nonlinear models of ambulatory and prescription drug mental health treatment. We find that in contrast to physical health treatment, Black-White and Hispanic-White disparities in any mental health treatment use widen with higher levels of psychological distress.