For many kids, adolescence heralds the onset of major depression along with the associated short- and long-term consequences. These include developmental and social impairment.
But many kids don’t receive treatment for the potentially life-threatening issue. New research has found persistent disparities based on race and ethnicity when it comes to who sees a therapist and who doesn’t.
In a recent study, researchers from the Rollins School of Public Health at Emory in Atlanta, Georgia, evaluated a national representative sample of 7,704 adolescents, from 12 to 17 years old, who were diagnosed with major depression within the past year.
The information came from analyzing five years of data (2004-2008) collected from the National Survey of Drug Use and Health (NSDUH).
The researchers studied the differences in treatment for depression across four racial/ethnic groups: non-Hispanic whites, blacks, Hispanics, and Asians.
Treatment disparities
After adjusting for demographics and health status, they found 40 percent of non-Hispanic whites received any major depression treatment, compared with 32 percent in blacks, 31 percent in Hispanics, and 19 percent in Asians.
Black, Hispanic, and Asian adolescents were also significantly less likely than non-Hispanic whites to receive treatment for major depression from mental health professionals, to receive treatment for major depression from medical providers, and to have any mental health outpatient visits, with Asians exhibiting the lowest rate of service use on each measurement.
The adjustment for socioeconomic status and health insurance status accounted for only a small portion of the estimated differences in major depression treatment measurements and outpatient utilization across racial/ethnic groups.
Other factors, such as stigma and limited proficiency in English, possibly contributed to the lower rates of service use in Hispanics and Asians.
Notably, one fourth of all adolescents with major depression received school-based counseling.
"Investment in quality improvement programs implemented in primary care settings as well as school-based mental health services may reduce unmet need for mental health services in all adolescents with major depression and reduce the sizeable differences in service use across racial/ethnic groups," said study lead authors Dr. Janet R. Cummings and Dr. Benjamin G. Druss.
Need for treatment
In a related editorial, Dr. Nicholas J. Carson said the low rates are “tragic,” considering the serious consequences of depression, which can include suicide, substance abuse, and academic failure.
"Future research will also need to clarify how a disproportionately low supply of mental health providers in minority communities affects disparities in access to services," said Carson.
The article "Racial/Ethnic Differences in Mental Health Service Use Among Adolescents With Major Depression," is printed in the February 2011 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
The NSDUH samples non-institutionalized individuals 12 years and older from all 50 states and the District of Columbia. The survey is conducted annually, in both English and Spanish, and is sponsored by the Substance Abuse and Mental Health Services Administration.
