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

TLDR

Clinical interventions, insurance expansion, and policy measures that lower financial barriers could reduce mental‑health care disparities. The study compared racial‑ethnic disparities in mental‑health care access among whites, blacks, Hispanics, and Asians from 2004‑2012. Data from 214,597 adults in the 2004‑2012 Medical Expenditure Panel Survey were analyzed. Racial‑ethnic disparities in mental‑health care access persisted and widened from 2004 to 2012, with black‑white and Hispanic‑white gaps increasing and no reductions observed.

Abstract

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.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).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%.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.