Racial/ethnic differences in mental health service use among adolescents with major depression

Abstract

Objective: Little is known about racial/ethnic differences in the receipt of treatment for major depression in adolescents. This study examined differences in mental health service use in non-Hispanic white, black, Hispanic, and Asian adolescents who experienced an episode of major depression.

Method: Five years of data (2004-2008) were pooled from the National Survey on Drug Use and Health to derive a nationally representative sample of 7,704 adolescents (12-17 years old) diagnosed with major depression in the past year. Racial/ethnic differences were estimated with weighted probit regressions across several measurements of mental health service use controlling for demographics and health status. Additional models assessed whether family income and health insurance status accounted for these differences.

Results: The adjusted percentages of blacks (32%), Hispanics (31%), and Asians (19%) who received any treatment for major depression were significantly lower than those of non-Hispanic whites (40%; p < .001). Black, Hispanic, and Asian adolescents were also significantly less likely than non-Hispanic whites to receive prescription medication for major depression, to receive treatment for major depression from a mental health specialist or medical provider, and to receive any mental health treatment in an outpatient setting (p < .01). These differences persisted after adjusting for family income and insurance status.

Conclusion: Results indicated low rates of mental health treatment for major depression in all adolescents. Improving access to mental health care for adolescents will also require attention to racial/ethnic subgroups at highest risk for non-receipt of services.

Conflict of interest statement

Disclosure: Drs. Cummings and Druss report have no biomedical financial interests or potential conflicts of interest.

Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Adjusted percentage of U.S. adolescents who received treatment for major depression by race/ethnicity. Note: N=7,618. Results from multivariate probit models adjusting for age, gender, family status, depression-related impairment, substance abuse/dependence, and self-rated health