Minorities Less Likely to Be Diagnosed with Mental Health Problems, Seek Treatment, Surgeon General’s Report Finds

There are "troubling disparities" in the mental health care that U.S. ethnic and racial minorities receive, according to a "broad and comprehensive" report released Aug. 26 by the surgeon general, the New York Times reports. The report, "Mental Health: Culture, Race and Ethnicity," used peer-reviewed research from such fields as mental health, history, sociology and anthropology to reach its conclusions and is a supplement to the 1999 "Surgeon General's Report on Mental Health" (Goode, New York Times, 8/27). The report found that African Americans with mental health problems are less likely than whites to be diagnosed and to receive proper care for those problems (Dunham, Reuters/Philadelphia Inquirer, 8/27). African Americans are also more likely than whites to be diagnosed "incorrectly"; for example, they are more likely to be diagnosed with schizophrenia than they are to be diagnosed with "less-severe mood disorder[s]." Compared with white young people, Latino youths are more likely to report depression, anxiety and suicidal thoughts, the report finds (Feder, San Jose Mercury News, 8/27). Overall, the study found that Latinos and Asian Americans are no more likely than whites to have mental disorders. However, Latinos might suffer disproportionately from mental health problems because they are the group with the lowest rate of health insurance. About 40% of Latinos are uninsured. Asian Americans are the least likely of all groups studied to seek mental health treatment. The report notes that only 17% of Asians with mental illnesses sought treatment. American Indians and Alaskan Natives are thought to have the "most limited" access to mental health care, the report says (Monmaney, Los Angeles Times, 8/27). Minorities are more likely than whites to "rely" on their primary care provider to detect mental health disorders, USA Today reports. But Ronald Kessler, health policy expert at Harvard Medical School, said that patients face "an uphill battle to get treatment for mental health problems under managed care," adding, "Doctors are not likely to diagnose a mental disorder in the eight minutes they're allowed with the patient" (Elias, USA Today, 8/27). Despite disparities in treatment and diagnosis, minorities generally respond to treatment similarly to whites when they receive proper diagnoses, the report finds (Reuters/Philadelphia Inquirer, 8/27).

Pinpointing the Reasons
According to the report, the disparities are due in part to the "fragmented, costly and inadequate mental health services" available to minorities, as well as to the high number of minorities who lack insurance. In addition, mental health problems among minorities are related to "cultural differences that created barriers to treatment," the report says. For instance, mental health providers are often unaware of their patients' cultural values and backgrounds, including their healing traditions and the "meaning of illness within their cultures," the New York Times reports. The report also notes that disparities in mental health care for minorities can be related to language differences, racism and discrimination, and to the stigma that some cultures ascribe to mental illness (New York Times, 8/27). Surgeon General David Satcher said, "While mental health disorders may touch all Americans either directly or indirectly, all do not have equal access to treatment and services. The revolution in science that has led to effective treatments for mental illness needs to benefit every American of every race, ethnicity and culture" (Reuters/Philadelphia Inquirer, 8/27). He added, "We have got to find a way to bridge the gap between the need and the access to services."

More Research, Tailor Services
Satcher called for additional research on minorities and mental health, noting that there is a "dearth of research" on the efficacy of various treatments in different minority groups. He added that "little was known" about mental illnesses in smaller racial and ethnic groups such as Asians, Pacific Islanders, American Indians and Alaska Natives. Satcher also recommended that mental health services be tailored to minorities and that the number of minority mental health care providers be increased (New York Times, 8/27). The federal government did not announce new programs or funding after the release of the study, which reports that care providers and state and local governments will be responsible for solving the problem. Still, Satcher said that he hoped NIH and other federal agencies would devise and fund initiatives for minority mental health. He added, "This is one of the best investments we can make" (Los Angeles Times, 8/27). The report is available online.