Simply relying on present health care systems without consideration of the unique barriers to quality care that ethnic and racial minority populations face is unlikely to affect the pattern of disparities observed. Populations reluctant to visit a clinic for depression care may have correctly anticipated the limited quality of usual care.

Objective: Prior work on racial/ethnic disparities in depression treatment has been limited by the scarcity of national samples that include an array of diagnostic and quality indicators and substantial non-English speaking minorities. Using nationally representative data (n=8762), we evaluate differences in access to and quality of depression treatments between ethnic/racial minority patients and non-Latino whites. Method: Access to mental health care was assessed by whether or not any mental health treatment was received in the past year. Quality treatment for acute depression was defined as four or more specialty/general health provider visits in the past year plus antidepressant use for 30 days or more; or eight or more specialty mental health provider visits of at least 30 minutes in length, with no antidepressant use. Results: For those with last year depressive disorder, 63.7% of Latinos, 68.7% of Asians and 58.8% of African Americans, vs. 40.2% of non-Latino whites, did not access any last year mental health treatment (significantly different at p<0.001). We also found that the disparities in the likelihood of both having access and receiving quality care for depression are significantly different for all minority groups as contrasted to non-Latino whites, except Latinos (marginally significant). Conclusion: Simply relying on present healthcare systems without considering the unique barriers to quality care that apply for ethnic and racial minorities is unlikely to affect the pattern of disparities observed. Populations reluctant to come to the clinic for depression care may have correctly anticipated the limited quality available in usual care.

We would also like to thank Janet Currie, Karen Norberg, and participants at the 2008 SOLE and ASHE meetings for very helpful suggestions. The views expressed herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peerreviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

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This paper investigates to what extent psychiatric disorders and mental distress affect labor market outcomes in two rapidly growing populations that have not been studied to date-ethnic minorities of Latino and Asian descent, most of whom are immigrants. Using data from the National Latino and Asian American Study (NLAAS), we examine the labor market effects of meeting diagnostic criteria for any psychiatric disorder in the past 12 months as well as the effects of psychiatric distress in the past year. The labor market outcomes analyzed are current employment status, the number of weeks worked in the past year among those who are employed, and having at least one work absence in the past month among those who are employed. Among Latinos, psychiatric disorders and mental distress are associated with detrimental effects on employment and absenteeism, similar to effects found in previous analyses of mostly white, American born populations. Among Asians, we find more mixed evidence that psychiatric disorders and mental distress detract from labor market outcomes. Our findings suggest that reducing disparities and expanding access to effective treatment may have significant labor market benefits-not just for majority populations, as has been demonstrated, but also for Asians and Latinos.