There hasn’t been a
look at whether
disparities in mental
health services have
2001, when a U.S.
that racial and
Now a 2015
APA book called
Research to Inform Effective Practice” fills that gap, with a series
of meta-analyses drawing on data from more than 4. 7 million
clients in 130 research studies.
“If there’s a larger meta-analysis in psychotherapy in terms
of numbers of clients, we’re not aware of it,” says Timothy B.
Smith, PhD, of Brigham Young University, who co-authored
the book with Joseph E. Trimble, PhD, of Western Washington
University. The book also includes meta-analyses on treatment
completion, therapist characteristics, culturally adapted services
and other areas.
The meta-analyses revealed that racial and ethnic
discrepancies have decreased somewhat, but are still substantial,
says Smith. African-Americans are 21 percent less likely than
white European-Americans to use mental health services, for
example. Hispanics and Latinos are 25 percent less likely. And
it’s not just a matter of socioeconomic status, adds Smith,
explaining that people have long assumed that differences in
income and health insurance access account for disparities.
“Our data show that race is an equally independent predictor of
mental health utilization,” he says.
The problem of underutilization is especially severe
for Asian-Americans, who are 51 percent less likely to take
advantage of mental health services than their white European-
American counterparts. “Across the studies, Asian-Americans
were by far the racial group that was most likely to underutilize
mental health services given their percentage in the population,”
The type of mental health services provided makes a
difference. Disparities among African-Americans disappeared
when they sought services in public, rather than private, service
settings, for example. “The obvious implication is that there’s
great benefit to public mental health services,” says Smith. “Every
effort should be made to maintain access to public services.”
The research also points to the need for greater specificity in
analyzing disparities, says Trimble. “If we’re setting up services
for African-Americans, who are we talking about — African-Americans from Haiti, from Boston, from Guatemala?” he says.
“There has to be more precision in how these labels are used in
the context of unscrambling the deep meaning of culture and
tailoring programs in ways that really reflect the deep cultural
meaning of who a person is.”
— Rebecca A. Clay
New from APA Publications
Who uses mental health services?
The meta-analyses in “Foundations of
Multicultural Psychology” reveal that racial
and ethnic minorities are less likely than white
European-Americans to use mental health
A new look at racial and ethnic disparities in mental health care
A new book finds racial and ethnic discrepancies have decreased somewhat, but are still substantial.