Mental Health Diagnoses and Treatment Vary With Race and Ethnicity

Study adds to growing body of research that depict disparities in care

A large study from Kaiser Permanente, involving more than seven million adults, found significant differences in the diagnosis and treatment of mental health conditions based on the race and ethnicity of the patients. The new study, published in the journal Psychiatric Services, also found that regardless of race or ethnicity, patients were more than twice as likely to receive medication for a mental health condition than formal psychotherapy.

“We studied mental health diagnoses and treatment using electronic health records rather than self-reported survey data from patients and physicians,” said Karen J. Coleman, PhD, study lead author, from Kaiser Permanente Southern California’s Department of Research and Evaluation. “Our study confirmed previous findings and adds to the growing body of evidence examining diagnosis and treatment of mental health conditions.”

Researchers analyzed the electronic medical records of 7.5 million adult patients across 11 health care systems participating in the Mental Health Research Network, a consortium of public-domain research centers. Of these patients, 1.17 million (15.6%) received a mental health diagnosis in 2011.

The study found that mental health diagnoses varied significantly by race and ethnicity. Native American/Alaskan Native patients had the highest rates of diagnosis (20.6%) while Asians had the lowest rates (7.5%). In general, the study found that patients from most racial and ethnic minority groups had much lower rates of mental health diagnosis compared to non-Hispanic white patients, ranging from 64% lower for Asian patients to 28% lower for Hispanic patients.

Diagnosis of specific mental health conditions such as depression and schizophrenia seemed to mirror this overall trend, with some exceptions. Non-Hispanic black patients were nearly twice as likely to be diagnosed with schizophrenia as non-Hispanic white patients. Treatment regimens also differed for non-Hispanic black patients, who were 35% less likely to receive medication for their schizophrenia but 2.64 times more likely to receive formal psychotherapy for this condition than their non-Hispanic white counterparts.

Overall, the study found that regardless of racial or ethnic background, patients diagnosed with a mental health condition were more likely to receive medication (73%) than to receive formal psychotherapy (34%) to treat these conditions.

“While further studies are needed to determine the cause for differences in diagnosis and treatment of mental health conditions based on racial or ethnic background, this study is important in showcasing that disparities exist and provides useful information for health care professionals who treat patients with mental health conditions,” Coleman added.

The patients in the study were enrolled in private, not-for-profit health care organizations that made up the Mental Health Research Network in the year 2011, including Kaiser Permanente (Southern California, Northern California, Hawaii, Colorado, and Northwest regions), Group Health Cooperative in Seattle, Baylor Scott & White Health/Central Texas VAMC in Temple, Texas, Henry Ford Health System in Detroit, Harvard Pilgrim Health Care in Boston, and HealthPartners in Bloomington, Minnesota.

Source: Kaiser Permanente, April 15, 2016.

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