Jansen Madeline O, Brown Tashalee R, Xu Kevin Y, Glowinski Anne L
Washington University School of Medicine, St. Louis, Missouri.
Washington University School of Medicine, St. Louis, Missouri; William Greenleaf Eliot Division of Child Psychiatry, Washington University School of Medicine, St. Louis, MO.
J Am Acad Child Adolesc Psychiatry. 2022 Oct;61(10):1211-1217. doi: 10.1016/j.jaac.2022.03.013. Epub 2022 Mar 28.
Racial inequity in mental health care quality is influenced by many systems-level factors, as elucidated by critical race theory, structural competency, and other keystone frameworks. A growing body of literature also suggests provider-level bias to be a key driver. There is specific evidence that racism is an important driver of health inequities among youth and that it is mediated, in part, by provider-level processes related to diagnosis and treatment. For example, in child and adolescent psychiatry, youth who are Black, Indigenous, and People of Color (BIPOC) experience disproportionate rates of delayed diagnosis and treatment of autism spectrum disorder, overdiagnosis of conduct disorder, and underdiagnosis of attention-deficit/hyperactivity disorder. Black and multiracial adolescents are at highest risk of suicide, yet are least likely to receive preventive psychotherapy..
正如批判种族理论、结构胜任力及其他关键框架所阐明的那样,心理健康护理质量方面的种族不平等受到许多系统层面因素的影响。越来越多的文献也表明,提供者层面的偏见是一个关键驱动因素。有具体证据表明,种族主义是青少年健康不平等的一个重要驱动因素,并且它部分是由与诊断和治疗相关的提供者层面的过程所介导的。例如,在儿童和青少年精神病学领域,黑人、原住民和有色人种(BIPOC)青少年在自闭症谱系障碍的诊断和治疗延迟、品行障碍的过度诊断以及注意力缺陷/多动障碍的诊断不足方面的比例过高。黑人和多族裔青少年自杀风险最高,但接受预防性心理治疗的可能性最小。