Cambridge Health Alliance, Cambridge, MA, USA.
Uniformed Services University of the Health Sciences, North Bethesda, MD, USA.
Med Care Res Rev. 2019 Dec;76(6):683-710. doi: 10.1177/1077558718780592. Epub 2018 Jun 7.
Racial/ethnic minorities in the United States are more likely than Whites to have severe and persistent mental disorders and less likely to access mental health care. This comprehensive review evaluates studies of mental health and mental health care disparities funded by the National Institute of Mental Health (NIMH) to provide a benchmark for the 2015 NIMH revised strategic plan. A total of 615 articles were categorized into five pathways underlying mental health care and three pathways underlying mental health disparities. Identified studies demonstrate that socioeconomic mechanisms and demographic moderators of disparities in mental health status and treatment are well described, as are treatment options that support diverse patient needs. In contrast, there is a need for studies that focus on community- and policy-level predictors of mental health care disparities, link discrimination- and trauma-induced neurobiological pathways to disparities in mental illness, assess the cost effectiveness of disparities reduction programs, and scale up culturally adapted interventions.
美国的少数族裔比白人更有可能患有严重且持续的精神障碍，获得精神卫生保健的机会也更少。本综合评价评估了美国国立精神卫生研究所（NIMH）资助的精神卫生和精神卫生保健差异方面的研究，为 2015 年 NIMH 修订的战略计划提供了基准。共有 615 篇文章分为精神卫生保健的五条途径和精神卫生差异的三条途径。已确定的研究表明，精神卫生状况和治疗方面差异的社会经济机制和人口统计学调节因素以及支持不同患者需求的治疗选择都得到了很好的描述。相比之下，需要开展一些研究来关注精神卫生保健差异的社区和政策层面预测因素，将歧视和创伤引起的神经生物学途径与精神疾病的差异联系起来，评估减少差异计划的成本效益，并扩大文化适应性干预措施。
