Abstract
Research on racial/ethnic differences in quitting mental health services has yet to examine the multiple forms of services offered and reasons why racial/ethnic groups quit. Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) examined whether race/ethnicity was related to quitting nine types of mental health services within a multivariate framework, and whether any racial/ethnic differences emerged among 16 assessed reasons for quitting mental health services (N = 437). Odds of quitting mental health services provided by social workers, non-medical health professionals, counselors, psychiatrists, and psychologists varied significantly by race/ethnicity. The most common reasons for quitting services included individuals wanting to handle the problem on their own, getting better, or not needing help anymore. The increased likelihood of quitting services represents an underexplored area for mental health service disparities and calls for improved efforts to retain racial and ethnic minorities in the mental health system.
Similar content being viewed by others
References
Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Archives of general psychiatry. 2005;62(10):1097–106.
Ferrari AJ, Charlson FJ, Norman RE, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Medicine. 2013;10(11):e1001547.
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997;349(9063):1436–42.
Andrade L, Caraveo-anduaga JJ, Berglund P, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. International journal of methods in psychiatric research. 2003;12(1):3–21.
Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289(23):3095–105.
Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-49, HHS Publication No. (SMA) 14–4887. Rockville, MD. 2014.
Bailey RK, Blackmon HL, Stevens FL. Major depressive disorder in the African American population: meeting the challenges of stigma, misdiagnosis, and treatment disparities. Journal of the national medical association. 2009;101(11):1084–9.
Atdjian S, Vega WA. Disparities in mental health treatment in U.S. racial and ethnic minority groups: implications for psychiatrists. Psychiatric services. 2005;56(12):1600–2.
Fortuna LR, Alegria M, Gao S. Retention in depression treatment among ethnic and racial minority groups in the United States. Depression and anxiety. 2010;27(5):485–94.
Harman JS, Edlund MJ, Fortney JC. Disparities in the adequacy of depression treatment in the United States. Psychiatric services. 2004;55(12):1379–85.
Cooper LA, Gonzales JJ, Gallo JJ, et al. The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients. Medical care. 2003;41(4):479–89.
O’brien A, Fahmy R, Singh SP. Disengagement from mental health services. A literature review. Social psychiatry and psychiatric epidemiology. 2009;44(7):558–68.
Shim RS, Baltrus P, Bradford LD, Holden KB, Fresh E, Fuller LE. Characterizing depression and comorbid medical conditions in African American women in a primary care setting. Journal of the national medical association. 2013;105(2):183–91.
Lesser IM, Zisook S, Gaynes BN, et al. Effects of race and ethnicity on depression treatment outcomes: the CO-MED trial. Psychiatric services. 2011;62(10):1167–79.
Manseau M, Case BG. Racial-ethnic disparities in outpatient mental health visits to U.S. physicians, 1993-2008. Psychiatric services. 2014;65(1):59–67.
Olfson M, Mojtabai R, Sampson NA, et al. Dropout from outpatient mental health care in the United States. Psychiatric services. 2009;60(7):898–907.
Arnow BA, Blasey C, Manber R, et al. Dropouts versus completers among chronically depressed outpatients. Journal of affective disorders. 2007;97(1–3):197–202.
Jarrett RB, Minhajuddin A, Kangas JL, Friedman ES, Callan JA, Thase ME. Acute phase cognitive therapy for recurrent major depressive disorder: who drops out and how much do patient skills influence response? Behaviour research and herapy. 2013;51(4–5):221–30.
Alegría M, Chatterji P, Wells K, et al. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatric services. 2008;59(11):1264–72.
Kessler RC, Merikangas KR. The National Comorbidity Survey Replication (NCS-R): background and aims. International journal of methods in psychiatric research. 2004;13(2):60–8.
Alegria M, Takeuchi D, Canino G, et al. Considering context, place and culture: the National Latino and Asian American Study. International journal of methods in psychiatric research. 2004;13(4):208–20.
Jackson JS, Torres M, Caldwell CH, et al. The National Survey of American Life: a study of racial, ethnic and cultural influences on mental disorders and mental health. International journal of methods in psychiatric research. 2004;13(4):196–207.
Heeringa SG, Wagner J, Torres M, Duan N, Adams T, Berglund P. Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International journal of methods in psychiatric research. 2004;13(4):221–40.
Pennell BE, Bowers A, Carr D, et al. The development and implementation of the National Comorbidity Survey Replication, the National Survey of American Life, and the National Latino and Asian American Survey. International journal of methods in psychiatric research. 2004;13(4):241–69.
Kessler RC, Abelson J, Demler O, et al. Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). International journal of methods in psychiatric research. 2004;13(2):122–39.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. 4th ed., text revision. Washington, DC, American Psychiatric Association; 2000.
StataCorp. Stata Statistical Software: Release 13. College Station, TX: StataCorp LPl 2013.
Kessler RC, Merikangas KR, Wang PS. Prevalence, comorbidity, and service utilization for mood disorders in the United States at the beginning of the twenty-first century. Annual review of clinical psychology 2007;3:137–58.
Kessler RC, Avenevoli S, Costello EJ, et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of general psychiatry. 2012;69(4):372–80.
Huang B, Grant BF, Dawson DA, et al. Race-ethnicity and the prevalence and co-occurrence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol and drug use disorders and Axis I and II disorders: United States, 2001 to 2002. Comprehensive psychiatry. 2006;47(4):252–7.
McCarthy, M. Prescription drug abuse up sharply in the USA. Lancet. 2007; 369(9572): 1505–1506.
Alvidrez J. Ethnic variations in mental health attitudes and service use among low-income African American, Latina, and European American young women. Community mental health journal. 1999;35(6):515–30.
Campbell, RD, Mowbray, O. The stigma of depression: Black American experiences. Journal of ethnic and cultural diversity in social work. 2017;25(4):253–269.
Cooper-patrick L, Powe NR, Jenckes MW, Gonzales JJ, Levine DM, Ford DE. Identification of patient attitudes and preferences regarding treatment of depression. Journal of general internal medicine. 1997;12(7):431–8.
Millet PE, Sullivan BF, Schwebel AI, Myers LJ. Black Americans’ and White Americans’ views of the etiology and treatment of mental health problems. Community mental health journal. 1996;32(3):235–42.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Approval
The research presented involves the use of secondary data, and was approved by the University Internal Review Board. Upon review of data documentation and survey methodology reported from the original Principal Investigators, we believe all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Mowbray, O., Campbell, R.D., Kim, I. et al. Quitting Mental Health Services among Racial and Ethnic Groups of Americans with Depression. J Behav Health Serv Res 45, 269–279 (2018). https://doi.org/10.1007/s11414-017-9560-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11414-017-9560-0