Racial and Ethnic Disparities Persist in Mental Health Care for Children

A recent study in the International Journal of Health Services found that there are racial and ethnic disparities in accessing mental health care for children and young adults. The authors used nationally representative data from the 2006-2012 Medical Expenditure Panel Surveys to examine children and young adults receipt of mental health care.

While African American and white children had similar inpatient and emergency department utilization rates, African American children had 37% fewer visits to psychiatrists and 47% fewer visits to any mental health professional when compared to white children. Hispanic children had lower inpatient utilization than both white and African American children and this trend persists in mental health care: Hispanic children had 49% fewer visits to psychiatrists and 58% fewer visits to any mental health professional than white children. As children become young adults (aged 18 to 34), the disparities expand. Overall visits to mental health professionals were 68% lower for African American and 62% lower for Hispanic young adults when compared to visits for white young adults.

The authors speculate on why the prevalence of psychiatric conditions is considered similar across racial and ethnic groups, yet African American and Hispanic children and young adults receive significantly less behavioral health care. One reason is that social stigma and mistrust of the health care system may create obstacles to accessing care. Also, primary care providers may fail to recognize mental illness or offer referrals for minority children and young adults. And when referrals are made, a shortage of child psychiatrists may impede access. Indeed, a CCF report that surveyed pediatricians in Florida found that the most difficult specialty to make referrals for children covered by Medicaid was behavioral/mental health services.

The authors conclude that mental health issues among minority youth often disproportionately result in punishment or incarceration, instead of health care. This stark contrast starts at a young age with African American children have higher rates of suspensions and expulsions, starting in preschool. Even modest gains in mental health treatment may lead to reductions in incarceration rates.