Racial/Ethnic Disparities in the Mental Health Care Utilization of Fifth Grade Children

Abstract

Objective-The aim of this study was to examine racial/ethnic differences in fifth grade children's mental health care utilization.Methods-We analyzed cross-sectional data from a study of 5147 fifth graders and their parents in 3 US metropolitan areas from 2004-06. Multivariate logistic regression was used to examine racial/ethnic differences in mental health care utilization.Results-Nine percent of parents reported that their child had ever used mental health care services; fewer black (6%) and Hispanic (8%) children had used services than white children (14%). Fewer black and Hispanic children with recent symptoms of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder, and fewer black children with symptoms of depression had ever utilized services compared with white children. In multivariate analyses controlling for demographic factors, parental mental health, social support, and symptoms of the 4 mental health conditions, we found that black children were less likely than white children to have ever used services (Odds ratio [OR] 0.3, 95% confidence interval [95% CI], 0.2-0.4, P <.001). The odds ratio for black children remained virtually unchanged when the analysis was restricted to children with symptoms of ≥1 mental health condition, and when the analysis was stratified by mental health condition. The difference in utilization for Hispanic compared with white children was fully explained by sociodemographics in all multivariate models.

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

“…9 In addition, racial/ethnic minorities who are diagnosed with ADHD have been reported to be less likely to use prescription medication. 2, 10 Hypothesized mechanisms for ADHD diagnosis and treatment disparities include less frequent access to health professionals and service utilization [11][12][13][14] and, when seen, less frequent solicitation by professionals of developmental concerns. 15 Additional hypothesized mechanisms include a lower likelihood of referral by school professionals, limited ability to pay for health care, and negative attitudes toward disability identification and treatment in some racial/ethnic subcultures.…”

Health Inequity in Children and Youth With Chronic Health Conditions

“…93 Poor and minority families are less likely to have a usual source of care, which may account for their use of fewer autism services and lower recognition of and treatment levels for ADHD and depression. 19,28,55,56 Minority patients with a disability are more likely to use emergency services and require hospitalization, 5 which correlates with the higher emergency department use and hospitalization rates of minority children with asthma.…”

“…54 Results of 2 other studies indicated that fewer black children with depression symptoms use mental health services than white children. 55,56 …”

Common and Costly Hospitalizations for Pediatric Mental Health Disorders

“…Previous studies of outpatient mental health care have shown that minority children are more likely to be undiagnosed 33,34 and that, among children with mental health diagnoses, black and/or Hispanic children are less likely to receive outpatient mental health services. [35][36][37][38][39] The increased adjusted likelihood of mental health hospitalization associated with…”