NIMH · A New Look at Racial/Ethnic Differences in Mental Health Service Use Among Adults
April 23, 2015 • Science Update
New findings on mental health service use by racial and ethnic groups are now available in a report by the Substance Abuse and Mental Health Services Administration (SAMHSA). “This is a wonderful resource,” said Pamela Collins, MD, NIMH director of the Office for Research on Disparities & Global Mental Health. “These findings will help us identify who is not getting the services they need and where the hurdles lie.”
The report, “Racial/Ethnic Differences in Mental Health Service Use among Adults,” is based on combined National Survey on Drug Use and Health (NSDUH) data from 2008 to 2012. Researchers looked at how often adults in different racial and ethnic groups sought mental health services in the past year. Findings include estimates of overall service use, medication use, outpatient and inpatient service use, as well as reasons for not using services.
The adults most likely to use mental health services in the past year (17.1%) were in the group reporting two or more races. This group was followed by white adults (16.6%), American Indian or Alaska Native adults (15.6%), followed by black (8.6), Hispanic (7.3) and Asian (4.9%) adults.
The racial/ethnic groups most likely to use a prescription for psychiatric medication were white adults (14.4%), adults reporting two or more races (14.1%), and American Indian or Alaska Native adults (13.6%), followed by black (6.5%), Hispanic (5.7%), and Asian (3.1%) adults.
Using outpatient mental health services in the past year was most common for adults reporting two or more races (8.8%), white adults (7.8%), and American Indian or Alaska Native adults (7.7%), followed by black (4.7%), Hispanic (3.8%), and Asian (2.5%) adults.
Using inpatient mental health services in the past year was more common among black adults (1.4%) than white adults (0.7%).
Cost of services / lack of insurance coverage was the most common reason for not using mental health services across all racial/ethnic groups. Believing that mental health services would not help was the least cited reason across all racial/ethnic groups.
A downloadable copy of “Racial/Ethnic Differences in Mental Health Service Use among Adults” is available on the SAMHSA website. The main report is here . The appendices are here .
Wendy of the blog Picnic with Ants (picnicwithants.com) describes her life as “a journey learning to live a happy and productive life, while living with Chronic Illnesses.” Today for the Blog Action Day theme of inequality, she wrote this incredibly powerful piece about her experience having been involuntarily hospitalized. She concludes by asking:
- Can you see how different it would have been for me if I had the financial means to pay for a higher quality facility, and have an advocate help me?
- Can you see how different it would have been for me if I had not had the financial means I had? If I hadn’t had insurance? …
- What can we do to stop the Inequality in the Mental Health Care System?
- The first thing we can do is talk about it.
- The more attention we call to it….the more noise we make about it…they will have to do something about it!
- …this is an inequality that must end! People cannot continue to suffer because they can’t afford mental health care.
I admit I had not heard of Blog Action Day until yesterday. I left a comment on fellow blogger Kitt O’Malley’s blog and she told me that it was worthy of a post for this year’s theme Inequality. Kitt is an amazing mental health advocate, please go and check out her blog. Kitt O’Malley – Living with Bipolar. Loved by God.
Inequality and Access to Mental Health Care
Sometimes you need help. You may or may not want it. You are a risk to yourself or others. A stay in a psychiatric facility is needed. The care you receive will vary drastically depending on your financial means.
This is my story…..a 30 something white woman, with not the best insurance, with no savings, and no other financial support….
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Structural factors such as poverty, inequality, homelessness, and discrimination contribute to risk for mental disability and impact negatively on the course and outcome of such disabilities. A human rights approach to mental disability means affirming the full personhood of those with mental disabilities by respecting their inherent dignity, their individual autonomy and independence, and their freedom to make their own choices.
~ Jonathan Kenneth Burns
Thank you, Jonathan Kenneth Burns, for writing “Mental health and inequity: A human rights approach to inequality, discrimination, and mental disability,” an excellent journal article published in Health and Human Rights. Jonathan Kenneth Burns, MBChB, MSc, FCPsych, is Senior Lecturer and Chief Specialist Psychiatrist in the Department of Psychiatry at the Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
What he has to say is well worth reading. Check out his whole journal article.
Mental disability and mental health care have been neglected in the discourse around health, human rights, and equality. This is perplexing as mental disabilities are pervasive, affecting approximately 8% of the world’s population. Furthermore, the experience of persons with mental disability is one characterized by multiple interlinked levels of inequality and discrimination within society. Efforts directed toward achieving formal equality should not stand alone without similar efforts to achieve substantive equality for persons with mental disabilities. Structural factors such as poverty, inequality, homelessness, and discrimination contribute to risk for mental disability and impact negatively on the course and outcome of such disabilities. A human rights approach to mental disability means affirming the full personhood of those with mental disabilities by respecting their inherent dignity, their individual autonomy and independence, and their freedom to make their own choices. A rights-based approach requires us to examine and transform the language, terminology, and models of mental disability that have previously prevailed, especially within health discourse. Such an approach also requires us to examine the multiple ways in which inequality and discrimination characterize the lives of persons with mental disabilities and to formulate a response based on a human rights framework. In this article, I examine issues of terminology, models of understanding mental disability, and the implications of international treaties such as the United Nations Convention on the Rights of Persons with Disabilities for our response to the inequalities and discrimination that exist within society — both within and outside the health care system. Finally, while acknowledging that health care professionals have a role to play as advocates for equality, non-discrimination, and justice, I argue that it is persons with mental disabilities themselves who have the right to exercise agency in their own lives and who, consequently, should be at the center of advocacy movements and the setting of the advocacy agenda.