Assari Shervin, Caldwell Cleopatra Howard
Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
Children (Basel). 2017 May 17;4(5):40. doi: 10.3390/children4050040.
Racial disparity in mental health service utilization (MHSU) persists, and youths are not an exception to the underutilization of services. Very limited research has been conducted on the determinants of MHSU among Black youth. Using a national sample of American Black youth, the current study investigated the association between demographic factors, socioeconomic status, psychiatric disorders, and self-rated health (SRH) on MHSU. We also tested the heterogeneity of the effects of SRH and psychiatric disorders based on ethnicity, gender, and their intersection. We used data from the National Survey of American Life-Adolescents supplement (NSAL-A), 2003-2004. The study enrolled 1170 Black youth between 13 and 17 years old including 810 African Americans and 360 Caribbean Blacks. Age, gender, ethnicity, socioeconomic status, SRH, 12-month psychiatric disorders (Composite International Diagnostic Interview modified version), and MHSU (last year) were measured. Logistic regressions were used for data analysis. Ethnicity (odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.17-0.65), subjective socioeconomic status (OR = 1.43, 95% CI = 1.09-1.88), SRH (OR = 2.45, 95% CI = 1.00-6.37), and psychiatric disorders (OR = 2.17, 95% CI = 1.05-4.48) were associated with MHSU. Age, gender, and objective socioeconomic status were not associated with MHSU. Gender and ethnicity did not interact with SRH and psychiatric disorders on MHSU. Actual and perceived need both universally influence Black youths' likelihood of MHSU, regardless of their ethnicity and gender. Ethnicity and perceived socioeconomic status also play unique roles in MHSU. Future research is needed to understand pathways to MHSU for Black youth who both have and perceive mental health needs. There is also a need to find ways to promote MHSU for those with a need for mental health services.
心理健康服务利用（MHSU）方面的种族差异依然存在，青少年在服务利用不足方面也不例外。针对黑人青少年心理健康服务利用的决定因素所开展的研究非常有限。本研究以美国黑人青少年的全国样本为基础，调查了人口统计学因素、社会经济地位、精神疾病和自评健康（SRH）与心理健康服务利用之间的关联。我们还基于种族、性别及其交叉情况，测试了自评健康和精神疾病影响的异质性。我们使用了2003 - 2004年美国生活青少年补充调查（NSAL - A）的数据。该研究招募了1170名13至17岁的黑人青少年，其中包括810名非裔美国人和360名加勒比黑人。对年龄、性别、种族、社会经济地位、自评健康、12个月内的精神疾病（复合国际诊断访谈修订版）以及心理健康服务利用情况（过去一年）进行了测量。采用逻辑回归进行数据分析。种族（比值比（OR）= 0.33，95%置信区间（CI）= 0.17 - 0.65）、主观社会经济地位（OR = 1.43，95% CI = 1.09 - 1.88）、自评健康（OR = 2.45，95% CI = 1.00 - 6.37）和精神疾病（OR = 2.17，95% CI = 1.05 - 4.48）与心理健康服务利用有关。年龄、性别和客观社会经济地位与心理健康服务利用无关。性别和种族在心理健康服务利用方面与自评健康和精神疾病不存在交互作用。实际需求和感知需求都普遍影响黑人青少年接受心理健康服务的可能性，无论其种族和性别如何。种族和感知到的社会经济地位在心理健康服务利用方面也发挥着独特作用。未来需要开展研究，以了解既有心理健康需求又感知到有心理健康需求的黑人青少年接受心理健康服务的途径。还需要找到方法来促进那些有心理健康服务需求者接受心理健康服务。
