Trends in Racial-Ethnic Disparities in Access to Mental Health Care, 2004-2012

Abstract

Objective: This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences.

Methods: Racial-ethnic disparities in mental health care access were examined by using data from a nationally representative sample of 214,597 adults from the 2004-2012 Medical Expenditure Panel Surveys. The main outcome measures included three mental health care access measures (use of any mental health care, any outpatient care, and any psychotropic medication in the past year).

Results: Significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access. Between 2004 and 2012, black-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.2% to 10.8% and from 7.6% to 10.0%. Similarly, Hispanic-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.4% to 10.9% and 7.3% to 10.3%.

Conclusions: No reductions in racial-ethnic disparities in access to mental health care were identified between 2004 and 2012. For blacks and Hispanics, disparities were exacerbated over this period. Clinical interventions that improve identification of symptoms of mental illness, expansion of health insurance, and other policy interventions that remove financial barriers to access may help to reduce these disparities.

Figure 1. Unadjusted trends in any mental health care by race/ethnicity 2004-2012^{a, b, c}

^aData: 2004-2012 Medical Expenditure Panel Surveys ^bN= 214, 597 ^cAll differences between whites and blacks, Hispanics, and Asians are significant (p<.05) ^‡Any mental health care of black/Hispanic/Asian and whites in the marked year is significantly different from the same group’s values in 2004