Mental Health Disparities by Race and Ethnicity of Adults

Published June 2019

The Psychiatric Services Editor’s Choice provides essential curated collections from recent issues of Psychiatric Services.  Each month, Editor Lisa Dixon and the Early Career Psychiatrist Advisory Committee offer a curated collection from the rich resource of articles published in the journal. Updates will focus on one area, summarizing for the researcher, clinician, and policy analyst the latest information and seminal research with links to specific content from Psychiatric Services.

The 2001 landmark Surgeon General’s report, Mental Health: Culture, Race, and Ethnicity, underscored significant disparities in initiation of and engagement in mental health care among persons from racial-ethnic minority groups. Now, almost 20 years later, these disparities persist, with higher rates of morbidity from decreased engagement in high-quality care, including use of evidence-based medications and psychotherapies. Reasons for lower treatment engagement are multifactorial and range from a lack of culturally informed treatment options to absence of a diverse mental health workforce, racism, mistrust of health care systems, variance in the quality of mental health treatment offered, and lack of attention to the social determinants of health. This collection highlights the severity of the problem among adults from racial and ethnic minority groups, with consideration of cultural issues related to higher attrition rates and structural challenges associated with access to care. It also highlights the importance of addressing key issues, such as stigma, and the value of including the patient in the decision-making process to improve mental health outcomes. We include possible solutions to these ongoing disparities, including integrated health care services, culturally informed evidence-based treatment interventions, partnership with faith-based organizations, and the need for a more diverse addiction workforce.

Please note that not all articles in this curated collection are available without a subscription. For access, learn about subscribing to Psychiatric Services.


Inequalities in Use of Specialty Mental Health Services Among Latinos, African Americans, and Non-Latino Whites
Margarita Alegría, Ph.D., Glorisa Canino, Ph.D., Ruth Ríos, Ph.D., Mildred Vera, Ph.D., José Calderón, M.S., Dana Rusch, B.A., and Alexander N. Ortega, Ph.D.
2002, Volume 53, Issue 12, pp. 1547–1555

Disparities in the Adequacy of Depression Treatment in the United States
Jeffrey S. Harman, Ph.D., Mark J. Edlund, M.D., Ph.D., and John C. Fortney, Ph.D.
2004, Volume 55, Issue 12, pp. 1379–1385

Measuring Trends in Mental Health Care Disparities, 2000–2004
Benjamin L. Cook, Ph.D., M.P.H., Thomas McGuire, Ph.D., Jeanne Miranda, Ph.D.
2007, Volume 58, Issue 12, pp. 1533–1540

Cultural Competence: A Literature Review and Conceptual Model for Mental Health Services
Mario Hernandez, Ph.D., Teresa Nesman, Ph.D., Debra Mowery, Ph.D., Ignacio D. Acevedo-Polakovich, Ph.D., Linda M. Callejas, M.A.
2009, Volume 60, Issue 8, pp. 1046–1050

Racial and Ethnic Disparities in Use of Psychotherapy: Evidence From U.S. National Survey Data
Jie Chen, Ph.D., John Rizzo, Ph.D.
2010, Volume 61, Issue 4, pp. 364–372

Psychiatrists’ Attitudes Toward and Awareness About Racial Disparities in Mental Health Care
Julie B. Mallinger, M.P.H., J. Steven Lamberti, M.D.
2010, Volume 61, Issue 2, pp. 173–179

Racial-Ethnic Disparities in Outpatient Mental Health Visits to U.S. Physicians, 1993–2008
Marc Manseau, M.D., M.P.H., and Brady G. Case, M.D.
2014, Volume 65, Issue 1, pp. 59–67

A Naturalistic Study of Racial Disparities in Diagnoses at an Outpatient Behavioral Health Clinic
Michael A. Gara, Ph.D., Shula Minsky, Ed.D., Steven M Silverstein, Ph.D., Theresa Miskimen, M.D., Stephen M. Strakowski, M.D.
2019, Volume 70, Issue 2, pp. 130–134

The Costs and Benefits of Reducing Racial-Ethnic Disparities in Mental Health Care
Benjamin Lê Cook, Ph.D., M.P.H., Zimin Liu, M.A., Anna Sophia Lessios, B.A., Stephen Loder, B.A., Thomas McGuire, Ph.D.
2015, Volume 66, Issue 4, pp. 389–396

Racial, Ethnic, and Gender Disparities in Health Care Access and Use Among U.S. Adults With Serious Psychological Distress
Judith Weissman, Ph.D., J.D., David Russell, Ph.D., Melanie Jay, M.D., M.S., Dolores Malaspina, M.D., M.P.H.
2018, Volume 69, Issue 5, pp. 517–522

Disparities in Access to Mental Health Services Among Patients Hospitalized for Deliberate Drug Overdose
Elizabeth Charron, M.P.H., Ellen C. Francis, M.S., Smith F. Heavner-Sullivan, M.S., R.N., Khoa D. Truong, Ph.D., M.Phil.
2019, Ahead of Print

Changes in Racial-Ethnic Disparities in Use and Adequacy of Mental Health Care in the United States, 1990–2003
Andrea Alexis Ault-Brutus, Ph.D., M.P.A.
2012, Volume 63, Issue 6, pp. 531–540

Racial-Ethnic Variation in U.S. Mental Health Service Use Among Latino and Asian Non-U.S. Citizens
Sungkyu Lee, Ph.D., Laurel Laiewski, M.S.S.W., and Sunha Choi, Ph.D.
2014, Volume 65, Issue 1, pp. 68–74

Research Issues for Improving Treatment of U.S. Hispanics With Persistent Mental Disorders
William Armando Vega, Ph.D., Marvin Karno, M.D., Margerita Alegria, Ph.D., Jennifer Alvidrez, Ph.D., Guillermo Bernal, Ph.D., Michael Escamilla, M.D., Javier Escobar, M.D., Peter Guarnaccia, Ph.D., Janis Jenkins, Ph.D., Alex Kopelowicz, M.D., Isabel T. Lagomasino, M.D., M.S.H.S., Roberto Lewis-Fernandez, M.D., Humberto Marin, M.D., Steven Lopez, Ph.D., Sana Loue J.D., Ph.D.
2007, Volume 58, Issue 3, pp. 385–394

Church-Based Health Programs for Mental Disorders Among African Americans: A Review
Sidney H. Hankerson, M.D., M.B.A., and Myrna M. Weissman, Ph.D.
2012, Volume 63, Issue 3, pp. 243–249

Improving Treatment Engagement of Underserved U.S. Racial-Ethnic Groups: A Review of Recent Interventions
Alejandro Interian, Ph.D., Roberto Lewis-Fernández, M.D., Lisa B. Dixon, M.D., M.P.H.
2013, Volume 64, Issue 3, pp. 212–222

Eliminating Behavioral Health Disparities and Improving Outcomes for Racial and Ethnic Minority Populations
Katherine Sanchez, Ph.D., L.C.S.W., Rick Ybarra, M.A., Teresa Chapa, Ph.D., M.P.A., Octavio N. Martinez, M.D., M.P.H.
2016, Volume 67, Issue 1, pp. 13–15

Change in Patient Activation and Mental Illness Symptoms After Communication Training: A Multisite Study With a Diverse Patient Sample
Mengchun Chiang, Ph.D., Janet Chang, Ph.D., Ora Nakash, Ph.D., Mario Cruz-Gonzalez, Ph.D., Mirko K. Fillbrunn, Ph.D., Margarita Alegría, Ph.D.
2019, Ahead of Print

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