Racial/Ethnic Differences in Perceived Reasons for Mental Health Treatment in US Adolescents With Major Depression

• Authors: Janet Cummings, Emory University; Brady G. Case, Brown University; Xu Ji, Emory University; David H. Chae, University of Maryland; Benjamin G Druss, Emory University
• Journal Title: Journal of the American Academy of Child and Adolescent Psychiatry
• Volume: Volume 53, Number 9
• Publisher: ELSEVIER SCIENCE INC | 2014-09-01, Pages 980-990
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.jaac.2014.05.016
• Subjects: Health Sciences, Health Care Management; Health Sciences, Public Health
• Keywords: Social Sciences; Science & Technology; Life Sciences & Biomedicine; Psychology, Developmental; Pediatrics; Psychiatry; Psychology; race/ethnicity; mental health services; depression; perceived treatment rationale; SUPPLEMENT NCS-A; HELP-SEEKING; CHILD; DISORDERS; DIAGNOSIS; RACE; AMERICAN

Abstract

Objective: Racial/ethnic differences in the course of treatment for a major depressive episode (MDE) among adolescents may arise, in part, from variation in the perceived rationale for treatment. We examined racial/ethnic differences in the perceived reasons for receiving mental health (MH) treatment among adolescents with an MDE. Method: A total of 2,789 adolescent participants who experienced an MDE and received MH treatment in the past year were drawn from the 2005 to 2008 National Survey on Drug Use and Health. Adolescents reported the settings in which they received care and reasons for their most recent visit to each setting. Distributions of specific depressive symptoms were compared across racial/ethnic groups. Racial/ethnic differences in endorsing each of 11 possible reasons for receiving treatment were examined using weighted probit regressions adjusted for sociodemographic characteristics, health and mental health status, treatment setting, and survey year. Results: Despite similar depressive symptom profiles, Hispanic adolescents were more likely than whites to endorse "breaking rules" or getting into physical fights as reasons for MH treatment. Black adolescents were more likely than white adolescents to endorse "problems at school" but less likely to endorse "felt very afraid or tense" or "eating problems" as reasons for treatment. Asian adolescents were more likely to endorse "problems with people other than friends or family" but less likely than whites to endorse "suicidal thoughts/attempt" and "felt depressed" as reasons for treatment. Conclusion: Racial/ethnic minority participants were more likely than white participants to endorse externalizing or interpersonal problems and less likely to endorse internalizing problems as reasons for MH treatment. Understanding racial/ethnic differences in the patient's perceived treatment rationale can offer opportunities to enhance outcomes for depression among diverse populations.