Disparities in mental health care access between Asian American and white patients are not completely accounted for by lower rates of perceived need among Asian American patients, according to results published in Psychiatry Services.
Kelly Guanhua Yang, BS, and colleagues at the Albert Einstein College of Medicine in New York assessed disparities in psychiatric care utilization between Asians and whites in the United States based on 2012 to 2016 data from the National Survey on Drug Use and Health. The survey captures substance use and mental health data from noninstitutionalized adults (aged 18 to 65 years) in the United States. Respondents were categorized into 3 subgroups: past year perceived need for mental health treatment; past year serious psychological distress; and past year major depressive episode. The primary outcome measure of the study was utilization of any form of mental health treatment in the past year. The investigators used multivariate logistic regression models to assess differences in mental health treatment patterns among patients.
The final study cohort comprised 108,404 white respondents (53.1% women) and 8121 Asian respondents (52.2% women). Asian participants were significantly less likely than white participants to report past year utilization of any mental health treatment (5.8% vs 19.0%; P <.001), which remained significant after adjustment for health and sociodemographic factors.
Additionally, 8.1% of Asian participants reported a self-perceived need for mental health treatment, compared with 22.7% of white participants (P <.001). However, compared with whites with perceived need, Asians with perceived need still had decreased odds of receiving mental health care in the past year (odds ratio [OR], 0.57; 95% CI, 0.44-0.75). Asians with past year serious psychological distress (OR, 0.32; 95% CI, 0.25-0.42) and a past year major depressive episode (OR, 0.31; 95% CI, 0.21-0.45) were less likely to receive care compared with their white counterparts (both P <.001). As a treatment barrier, Asians were more likely than whites to endorse not knowing where to go to receive mental health care (OR, 1.61; 95% CI, 1.09-2.39; P =.017), although they were less likely to identify cost as a barrier (OR, 0.63; 95% CI, 0.43-0.94; P =.024).
The findings demonstrate significant disparities in mental health care between Asian and white patients, even when adjusting for lower rates of self-perceived need for care among Asian respondents.
As a study limitation, the investigators noted that more granular information on participants’ specific ethnic or immigration backgrounds were not available. “Outreach conducted in Asian communities could improve awareness of mental illness and make care more accessible for those in need. Peer outreach in particular may be helpful, and health centers should consider recruiting community-specific volunteers to encourage information dissemination,” the investigators recommended.
Yang KG, Rodgers CRR, Lee E, Lê Cook B. Disparities in mental health care utilization and perceived need among Asian Americans: 2012-2016. Psychiatr Serv. 2020;71(1):21-27.