1 - (SYM 77) Racial and Ethnic Trends in Mental Health Service Utilization and Perceived Unmet Need

in the United States

Importance: Nearly two decades ago, the Surgeon General issued a report drawing attention to concerning disparities in mental healthcare among racial and ethnic minority populations. Whether mental health treatment utilization has changed over time across racial and ethnic groups has yet to be comprehensively assessed.

Objective: The present study characterizes national trends in mental health treatment utilization by race and ethnicity across a 13-year period.

Design, Setting, and Participants: Nationally representative data were drawn from the National Survey on Drug Use and Health from 2008 through 2020 (unweighted n = 441,993).

Main Outcomes and Measures: Trends in twelve-month prevalence of mental health treatment utilization and perceived unmet treatment need among individuals with and without psychiatric illness were observed and stratified by race and ethnicity.

Results: Results of logistic regression analyses revealed persistent disparities, with most racial/ethnic minority groups less likely to receive treatment than White individuals, regardless of mental health status. Treatment utilization increased over the 13-year study period among those with (annual percent change [APC]=.83, 95% CI=.41–1.26) and without psychiatric illness (APC=1.39, 95% CI=.53–2.26). However, most individuals with mental illness did not receive treatment. Among individuals with psychiatric illness, treatment use increased only among White (APC=.88, 95% CI=.51–1.24), Hispanic (APC=2.12, 95% CI=.70–3.57), and Black adults (APC = 1.07, 95% CI = .11–2.04). White (APC=1.88, 95% CI=.86–2.91) and Hispanic (APC=2.45, 95% CI=.02–4.93) individuals without psychiatric illness also saw increased treatment use.  Increases in perceived unmet treatment need were observed for all racial and ethnic groups except Blacks and Native Americans with psychiatric illness, and low rates of perceived unmet need were observed across all groups.

Conclusions and Relevance: Racial and ethnic differences in treatment use have persisted across the study period. Furthermore, although national rates of mental health treatment utilization have risen, this may be largely driven by increased treatment among White individuals with and without psychiatric illness and the absence of reductions in unmet need in minority populations. Collectively, these findings highlight the limited progress made towards eliminating disparities in mental healthcare.