Help-seeking at the intersection of race and age: Perceived need and treatment access for depression in the United States.

Race/ethnicity and age are well-documented factors that influence help-seeking variables for adults with depression, yet the intersection of race/ethnicity and age on help-seeking is less known. The present study examined the intersection of race/ethnicity (comparing racial minority groups to White adults) and age on perceived need, treatment access, and unmet need for mental health services among adults with a past-year major depressive episode (N = 35,033) using data from the 2010-2019 waves of the National Survey on Drug Use and Health. After controlling for age, Black (OR = 0.50), Hispanic (OR = 0.50), Pacific Islander (OR = 0.23), and Asian (OR = 0.39) respondents had lower odds of perceiving need (p's < .001); Black (OR = 0.62), Asian (OR = 0.62), Hispanic (OR = 0.77), and multiracial respondents (OR = 0.75) had lower odds of accessing treatment (p's < .05); and Black (OR = 1.38) and Hispanic (OR = 1.19) respondents had higher odds of reporting an unmet need (p's < .05). After controlling for race, younger and older adults had lower odds of perceiving a need (p's < .05) compared to middle-aged adults. Younger adults had lower odds of accessing treatment and higher odds of experiencing an unmet need (p's < .001). An interaction revealed that Black adults were less likely to perceive need than White adults (p < .001), and this gap was especially large among younger members of both groups (p = .020). These results extend previous research by highlighting the intersection of race/ethnicity and age on help-seeking, with implications for culturally competent and age-appropriate interventions, while emphasizing the need for racial/age equity in the mental health care system.