Disparities/Minority Health

Whites with poor mental health are more likely to seek treatment than blacks and Hispanics

Many people who suffer from mental health disorders do not seek treatment. Agency for Healthcare Research and Quality researchers Samuel H. Zuvekas, Ph.D., and John A. Fleishman, Ph.D., used Medical Expenditure Panel Survey data from 2001 to 2004 to delve into why minorities seek mental health services less frequently than whites. Researchers used respondents' self-reported mental health (SRMH) assessment and a survey that provides a summary score for emotional functioning to study 55,025 person-year observations.

Nearly 70 percent of those surveyed reported "excellent" or "very good" SRMH, with just 7 percent reporting "fair" or "poor" SRMH. Whites were more likely than blacks or Hispanics to associate their mental symptoms with their mental health status. The authors suggest that racial-ethnic groups may differ in their tendency to associate mental health problems with symptoms. This self assessment may partially explain why blacks and Hispanics do not seek mental health services as frequently as whites do.

Whites, blacks, and Hispanics with similar SRMH also use mental-health-related medications at different rates. The probability of whites using medication increased from .09 when they reported "excellent" SRMH to .41 when they reported "poor" SRMH. For blacks, the probability rose from .03 for "excellent" SRMH to .17 for "poor" SRMH; for Hispanics, the probability increased from .05 for "excellent" SRMH to .23 for "poor" SRMH. These results suggest that the gap between whites, blacks, and Hispanics using mental health services is likely caused by underuse by minorities and not overuse by whites.

See "Self-rated mental health and racial/ethnic disparities in mental health service use," by Drs. Zuvekas and Fleishman in the September 2008 Medical Care 46(9), pp. 915-923. Reprints (AHRQ Publication No. 09-R007) are available from the AHRQ Publications Clearinghouse.

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