Disparities in assessment, treatment, and recommendations for specialty mental health care: patient reports of medical provider behavior.

OBJECTIVE: To examine perceptions of medical doctor behavior in mental health (MH) utilization disparities.

DATA SOURCES: Secondary data analyses of the National Comorbidity Survey-Replication and the National Latino and Asian American Study (2001-2003).

STUDY DESIGN: Sample included non-Hispanic whites (NHWs), blacks, Asians, and Latinos. Dependent variables were patient reports of providers' assessment of and counseling on MH and substance abuse (SA) problems, and recommendation for medications or specialty MH care. The initial sample consisted of 9,100 adults; the final sample included the 3,447 individuals who had been asked about MH and SA problems.

PRINCIPAL FINDINGS: Bivariate analyses indicated that Asians were the least likely to report being assessed, counseled, and recommended medications and specialty care. In multivariate logistic regression analyses, there were no racial/ethnic differences in assessment of MH or SA problems. Compared to NHWs, black patients were less likely to report receiving a medication recommendation. Latinos were more likely to report counseling and a recommendation to specialty care. U.S.-born patients were more likely to report a medication recommendation.

CONCLUSIONS: Perceptions of provider behavior might contribute to documented disparities in MH utilization. Further research is needed to determine other points in the treatment utilization process that might account for racial/ethnic disparities.