This study will analyze data from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), to study whether disparities exist in medication use in this nationally representative sample of adolescents. We will examine variables that may correlate with these disparities in an effort to fill the knowledge gap and make recommendations to improve the effectiveness of identification, referral and screening for mental health disorders in racial/ethnic minority adolescents.
The Surgeon General’s Report on Mental Health: Culture, Race and Ethnicity as well as the President’s New Freedom Commission on Mental Health identify elimination of disparities in mental health as vital to allowing children and adults with mental illness to fully participate in their communities. Despite the prevalence of mental health disorders, over one-third of children with these disorders do not receive mental health services. Most psychiatric disorders have an onset in childhood and adolescence and lead to increased risk of poor physical health and affect educational attainment. The 2009 Institute of Medicine Report on Adolescent Health estimated that mental, emotional and behavioral disorders in youth take an enormous toll on the well being of youth and their families and costs an estimated $247 billion dollars annually.. Previous studies have indicated higher rates of unmet need for mental health services in racial and ethnic minority children and adolescents. The Center for Minority Mental Health Research was awarded a 2-year NIH Challenge grant to use data from the NCS-A to study “Reducing Ethnic and Racial Bias in Screening for Psychiatric Disorders in Adolescents.” Then NCS-A is the most comprehensive national data available to study screening and referral patterns for racial/ethnic minority children. Dr. Alegria is the Principal Investigator and her team works together with co-applicant Dr. Ronald Kessler and his group at the Department of Health Care Policy at Harvard Medical School.
Data from the NCS-A was analyzed to identify the racial and ethnic disparity in medication use in the sample of adolescents. A structured review of the literature was conducted to evaluate the research defining the etiology of the disparity and correlated variables. Results from this study will be used in the Center’s eventual creation of more effective screening procedures that may reduce disparities in access to mental health services. Recommendations will also be made to improve existing screening procedures for Latinos, African-American and non-Latino white Adolescents.
Based on preliminary data analysis and literature review there are differences in recognition of mental health disorders in racial and ethnic minority adolescents. Further, though there was a similar rate of severe emotional disorders across racial and ethnic groups in the survey sample, there were disparate rates of medication treatment across these groups with greater disparities seen between black and non-Latino white youth. Preliminary results also point to a gender effect with lower rates of medication use seen in black female youth.
Racial and ethnic disparities in medication use in this nationally representative sample of adolescents were reported. Additional correlates of these disparities will be further explored. This data will help to develop and inform more effective and appropriate screening for mental health disorders in racial and ethnic minority youth.
Margarita Alegria PhD, Director, Center for Multicultural Mental Health Research, Cambridge Health Alliance
Center for Multicultural Mental Health Research, Cambridge Health Alliance