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How do minorities differ in their diagnoses and treatment?

It is estimated that one-fourth of American adults are affected by a mental disorder at some point in their lives. Two-thirds of these individuals never seek help from a physician or mental health care professional. In the psychiatric community, it is well known that significant disparities exist in the delivery and receipt of mental health care, especially for individuals of different racial and ethnic minority groups in the United States. For example, racial and ethnic minorities are less likely to be diagnosed and treated for mental disorders, often receive a lower quality of care and have less accessible behavioral health treatment services available to them, according to the Supplement to Mental Health: A Report from the Surgeon General.

A recent study by Karen J. Coleman, Ph.D., M.S., an adjunct professor at the Keck School of Medicine in Los Angeles, California, and her colleagues, investigated the racial and ethnic differences in the diagnosis of mental disorders and the delivery of treatment, including psychotropic medications and psychotherapy. Eleven private, not-for-profit health care organizations with over 7 million patients over the age of 18 who had received care in 2011 were included in the study. Coleman and her colleagues indicated that people of different races and ethnicities do in fact differ in their psychiatric diagnoses and receipt of psychotropic medications.

Psychiatric diagnoses by race/ethnicity

The researchers determined psychiatric diagnoses using the standard International Classification of Diseases, ninth revision (ICD-9) codes.  In total, 15.6 percent of the 7.5 million patients included in the study had received a psychiatric diagnosis in 2011. The researchers found the following diagnosis rates for any mental disorder by race and ethnicity:

  • 20.6 percent of Native Americans and Alaskan Natives (highest)
  • 19.8 percent of non-Hispanic whites
  • 14.6 percent of mixed race and ethnicity
  • 14.3 percent of Hispanics
  • 13.5 percent of non-Hispanic blacks
  • 12.0 percent of those with unknown or missing race and ethnicity
  • 7.5 percent of Asians (lowest)

Compared with other racial and ethnic groups, whites had the higher rates of diagnoses for mental disorders, with the exception of Native Americans and Alaskan Natives. The researchers also found that non-Hispanic blacks had two times the odds of receiving a schizophrenia diagnosis as non-Hispanic whites.

Mental health treatment by race/ethnicity

Coleman and her colleagues collected information on psychotropic medications from pharmacy records. They also used electronic medical records (EMR) data to determine whether patients had received any formal psychotherapy for treatment of mental disorders. About 73 percent of patients who had been diagnosed with a mental disorder had received psychotropic medications. The researchers found that white patients (77.8 percent) were significantly more likely to receive psychotropic medications compared to people of racial and ethnic minority groups.

On the other hand, only 34 percent of patients with a psychiatric diagnosis had received formal psychotherapy. One of the major findings regarding psychotherapy treatment was that non-Hispanic blacks had a greater likelihood of receiving formal psychotherapy for schizophrenia and depression when compared to whites.

Coleman and her colleagues found evidence for clear differences that exist in the diagnosis and treatment of mental illness among people of racial and ethnic groups.  Native Americans, Alaskan Natives and whites had similar diagnosis rates for psychiatric disorders, while Asians were least likely to receive a diagnosis for a mental disorder. In regards to treatment, non-Hispanic whites were more likely to receive psychotropic medications compared to racial and ethnic minorities. Relatively few patients (34 percent) actually received formal psychotherapy.

It is important to overcome disparities and treatment barriers to allow people of different racial and ethnic minority groups to gain better access to behavioral health treatment.  Sovereign Health of Texas provides comprehensive, individualized behavioral health treatment services for patients who have substance use disorders and co-occurring disorders. Treatment programs are individualized and services are provided to both English and Spanish-speaking patients at this facility. For more information, please contact our 24/7 helpline.

About the author

Amanda Habermann is a staff writer for Sovereign Health. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. Her master’s thesis was written on “The effect of parental codependency on elementary school children’s social and emotional development,” and her research has been accepted for poster presentations at the Western Psychological Association. She brings to the team her extensive clinical background and skills in psychological testing and assessment, clinical diagnosis, research and treatment, and recovery techniques for patients with mental illness. She is a passionate researcher and enjoys staying up to date on the newest topics in the field. For more information and other inquiries about this article, contact the author at news@sovhealth.com.

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