Race and Beliefs About Mental Health Treatment Among Anxious Primary Care Patients

Published in: Journal of Nervous & Mental Disease, v. 201, no. 3, Mar. 2013, p. 188-195

Posted on RAND.org on March 01, 2013

by Justin Hunt, Greer Sullivan, Denise A. Chavira, Murray Stein, Michelle G. Craske, Daniela Golinelli, Peter Roy-Byrne, Cathy D. Sherbourne

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Research Question

  1. Do differences in treatment preferences explain racial disparities in mental health care?

Large racial disparities in the use of mental health care persist. Differences in treatment preferences could partially explain the differences in care between minority and nonminority populations. We compared beliefs about mental illness and treatment preferences between adult African-Americans, Hispanics, Asian Americans, Native Americans, and White Americans with diagnosed anxiety disorders. Measures of beliefs about mental illness and treatment were drawn from the National Comorbidity Survey Replication and from our previous work. There were no significant differences in beliefs between the African-Americans and the White Americans. The beliefs of the Hispanics and the Native Americans were most distinctive, but the differences were small in magnitude. Across race/ethnicity, the associations between beliefs and service use were generally weak and statistically insignificant. The differences in illness beliefs and treatment preferences do not fully explain the large, persistent racial disparities in mental health care. Other crucial barriers to quality care exist in our health care system and our society as a whole.

Key Finding

  • Persistent racial disparities in mental health care are not driven by differences in treatment preferences across ethnic and racial groups.

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