Amsterdam Municipal Health Service, Nieuwe Achtergracht 100, 1000 CE, Amsterdam, the Netherlands.
Psychiatr Serv. 2010 Jul;61(7):690-7. doi: 10.1176/ps.2010.61.7.690.
There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands.
Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses.
When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch.
The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded.
少数民族群体在心理健康治疗方面存在差异，这引起了广泛关注。然而，该领域的先前研究主要集中在美国和英国，这使得人们对其他欧洲国家的外部有效性产生了怀疑。本研究旨在探讨荷兰门诊治疗抑郁症的种族差异。
从全国性精神病患者登记处提取了 2001 年至 2005 年的纵向数据。样本包括 17270 例门诊抑郁症治疗。初始治疗接触的及时性、治疗强度、脱落率和心理健康护理的早期重新登记等信息均可用。采用线性、逻辑和 Cox 回归分析进行数据分析。
在控制疾病和人口统计学特征后，与荷兰族裔相比，摩洛哥人、土耳其人和其他非西方客户的初始治疗接触及时性和治疗强度略低。少数民族与荷兰族裔在脱落和早期重新登记方面没有发现显著差异。与荷兰族裔相比，一些治疗特征实际上对苏里南和荷属安的列斯群岛客户更为有利。
数据对治疗特征普遍对少数民族群体不利的观点提供的支持不足。这一发现可能与主流心理健康服务中促进对文化敏感的护理方法有关，但也可能表明传统障碍（如污名和禁忌）的作用比通常所暗示的要小。然而，语言能力的影响不应被忽视，与土耳其人和摩洛哥客户相比，苏里南和荷兰安的列斯群岛客户的语言能力明显更好。
