Race differences in psychopathology and disparities in treatment seeking: Community and jail-based treatment-seeking patterns.

Abstract

Whites in community samples utilize mental health services at a much higher rate than African Americans (Kessler, et al., 2005). Is this also the case among those in jails? In this study of jail inmates (229 African American, 185 White) there were no race difference in the overall need for mental health treatment (63% of participants had significant symptoms on the Personality Assessment Inventory) but race differences in the level and types of symptoms were evident. Additionally, while Whites were more likely to report pre-incarceration treatment there were no differences in treatment seeking or access to mental health programs while in jail, implying that if barriers to treatment in the community were removed (cost/insurance, location/transportation, time) racial disparities in treatment utilization may be reduced.

Why Do Some Jail Inmates Not Engage in Treatment and Services?

“…Hispanic inmates participated at a significantly higher rate than Caucasian and African American inmates, χ 2 (2, N = 186) = 6.86, p = .032; 76.9% of Hispanic inmates in need of treatment (N = 10) participated in drug or alcohol treatment compared to 38.8% of African American inmates (N = 38), and 45.3% of Caucasian inmates (N = 34). In sharp contrast to community samples, regardless of ethnicity, inmates in need participated at similar rates for most types of treatment programs (for a report on race differences in treatment seeking as opposed to participation see Youman, Drapalski, Stuewig, Bagley, & Tangney, 2010). …”

The Development of a Brief Jail-Based Cervical Health Promotion Intervention

“…To that end, an important addition to the intervention would be the inclusion of sessions on the role of race, ethnicity, and culture in beliefs about cervical cancer, for example, acknowledging participants’ stories about cancer, sex, reproduction, and health care seeking across race, ethnic, and cultural lines (Birhanu et al, 2012; Sims, 2010). A second example of a needed intervention component would be a session on how race, ethnic-, gender-, class-, and criminal justice history–based discrimination relates to sex and preventive health care–seeking behaviors (Richie, Freudenberg, & Page, 2001; Youman, Drapalski, Stuewig, Bagley, & Tangney, 2010). …”

Substance Use Correlates of Depression among African American Male Inmates

“…Among jail inmates, African Americans do not experience a greater burden of mental illness than Whites, yet they do experience differences in treatment in the community prior to arrest. 12 African American jail inmates were found to be less likely to report receiving mental health treatment prior to arrest compared with White inmates. 12 However, when provided with access to treatment while incarcerated, there were no differences in utilization of treatment between African American and White jail inmates.…”

“…12 However, when provided with access to treatment while incarcerated, there were no differences in utilization of treatment between African American and White jail inmates. 12 It would stand to reason that race-related differences in treatment persist once an inmate is released from jail and returns to their community because the same barriers to access to treatment are present or may even be exacerbated due to the stigma of incarceration.…”