Emory University School of Medicine, Atlanta, GA, USA.
Robert Graham Center, Washington, DC, USA.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720966403. doi: 10.1177/2150132720966403.
To estimate racial/ethnic differences in the extent to which mental health treatment is obtained from mental health providers, primary care physicians (PCPs), or both and to examine the effects of provider type on change in mental component scores (MCS) of the SF-12 on different race/ethnic groups.
Secondary data analysis of 2008 to 2015 Medical Expenditure Panel Survey (MEPS). Non-institutionalized civilian US population, aged 18 to 64 (N = 62 558). Based on counts of all mental health visits in a calendar year, we identified patients who obtained care from PCPs, mental health provider, PCP and mental health providers and other providers and examined changes in MCS by type of care.
9.9% of Non-Hispanic Whites obtained mental health treatment, compared to 5.0% for Hispanics, 5.3% for Blacks and 5.5% for Other Races ( < .001). Non-Hispanic Blacks and non-Hispanic "Other" were more likely than other groups to obtain care from mental health providers only ( = .017). All obtaining care solely from PCP had better mental health (mean (se)) MCS: 43.2(0.28)) than those obtaining care solely from mental health provider (39.8 (0.48)), which in turn was higher than for those obtaining care from both PC and MH providers (38.5 (0.31), ( < .001).
Even when diagnosed with a mental health disorder, Hispanics and Blacks were less likely to seek mental health treatment than Whites, highlighting the continuing disparity. Future research should focus on understanding how and what aspects of integrated care models and other mental health delivery models that reduce disparities and provide greater accessibility.
评估心理健康治疗在多大程度上来自心理健康提供者、初级保健医生(PCP)或两者兼而有之,以及检查提供者类型对 SF-12 心理成分评分(MCS)在不同种族/族裔群体中的变化的影响。
对 2008 年至 2015 年医疗支出调查(MEPS)进行二次数据分析。非机构化的美国平民人口,年龄在 18 至 64 岁之间(N=62558)。根据一年内所有心理健康就诊次数的计数,我们确定了从 PCP、心理健康提供者、PCP 和心理健康提供者以及其他提供者处获得治疗的患者,并检查了不同类型治疗的 MCS 变化。
9.9%的非西班牙裔白人获得了心理健康治疗,而西班牙裔为 5.0%,黑人为 5.3%,其他种族为 5.5%(<0.001)。非西班牙裔黑人和非西班牙裔“其他”比其他群体更有可能仅从心理健康提供者处获得治疗(=0.017)。所有仅从 PCP 处获得治疗的人心理健康状况更好(平均(se)MCS:43.2(0.28)),而仅从心理健康提供者处获得治疗的人(39.8(0.48))则更高,而从 PCP 和 MH 提供者处获得治疗的人(38.5(0.31))则更高,(<0.001)。
即使被诊断出患有心理健康障碍,西班牙裔和非裔美国人寻求心理健康治疗的可能性也低于白人,这突出了持续存在的差距。未来的研究应重点关注了解如何以及哪些方面的综合护理模式和其他心理健康提供模式可以减少差距并提供更大的可及性。