Ethnic Differences and Similarities in Outpatient Treatment for Depression in the Netherlands

Abstract

There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands. Methods: Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses. Results: When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch. Conclusions: The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded. (Psychiatric Services 61:690-697, 2010) H He en nk k H He ei ij jn ne en n, , M M. .S Sc c. . P Pi im m C Cu ui ij jp pe er rs s, , P Ph h. .D D. . A Ar rn no ou ud d V Ve er rh ho oe ef ff f, , P Ph h. .D D. . A Aa ar rt tj ja an n B Be ee ek km ma an n

Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands

“…Thus, the results of this study do not support the general idea that non-Western ethnic minority patients are less likely to receive guideline-concordant care for CMD. And as such, these results are quite in line with several other recent studies from the Netherlands, which paint a more optimistic picture regarding ethnic minority patients in mental health care [65][66][67][68]. Without thus trying to ignore the statistically significant unfavorable associations which we did find, we believe it is important to acknowledge that the Netherlands -like many other Western countries -nowadays has a considerable history of adapting (mental) health services to suit clients from different cultures [69,70].…”

The influence of acculturation on mental health and specialized mental healthcare for non-western migrants

“…Since the 1970s, Surinamese migrants have arrived in the Netherlands as well, because of unfavorable economic circumstances in Suriname. As Suriname is a former Dutch colony, most of these migrants master the Dutch language (Fassaert, 2011). According to research in the Dutch general population, Surinamese migrants show the highest degree of cultural adaptation, followed by Moroccan migrants and then by Turkish migrants (Kamperman, Komproe, & De Jong, 2003).…”

Comorbidity of anxiety and depressive disorders: A comparative population study in Western and non-Western inhabitants in the Netherlands

“…Several explanations have been suggested, including inappropriate help-seeking behaviour, under-detection, cross-cultural diagnostic difficulties and inappropriate treatment (Fassaert et al, 2009a;Kirmayer, 2001;Simon et al, 2002;Swinnen and Selten, 2007). Recent studies in the Netherlands have shown comparable access and largely comparable administrative indicators (frequency of visits, drop-out) of psychiatric treatment of ethnic minority patients with depressive or anxiety disorders (Fassaert et al, 2009b(Fassaert et al, , 2010. In the USA, decline in ethnic disparities in detection and treatment of these common mental disorders has also been noticed (Stockdale et al, 2008).…”