Depression Care in the United States: Too Little for Too Few
Open accessAbstract
OBJECTIVE: To determine the prevalence and adequacy of depression care among different ethnic and racial groups in the United States. DESIGN: Collaborative Psychiatric Epidemiology Surveys (CPES) data were analyzed to calculate nationally representative estimates of depression care. SETTING: The 48 coterminous United States. PARTICIPANTS: Household residents 18 years and older (N = 15 762) participated in the study. MAIN OUTCOME MEASURES: Past-year depression pharmacotherapy and psychotherapy using American Psychiatric Association guideline-concordant therapies. Depression severity was assessed with the Quick Inventory of Depressive Symptomatology Self-Report. Primary predictors were major ethnic/racial groups (Mexican American, Puerto Rican, Caribbean black, African American, and non-Latino white) and World Mental Health Composite International Diagnostic Interview criteria for 12-month major depressive episode. RESULTS: Mexican American and African American individuals meeting 12-month major depression criteria consistently and significantly had lower odds for any depression therapy and guideline-concordant therapies despite depression severity ratings not significantly differing between ethnic/racial groups. All groups reported higher use of any past-year psychotherapy and guideline-concordant psychotherapy compared with pharmacotherapy; however, Caribbean black and African American individuals reported the highest proportions of this use. CONCLUSIONS: Few Americans with recent major depression have used depression therapies and guideline-concordant therapies; however, the lowest rates of use were found among Mexican American and African American individuals. Ethnic/racial differences were found despite comparable depression care need. More Americans with recent major depression used psychotherapy over pharmacotherapy, and these differences were most pronounced among Mexican American and African American individuals. This report underscores the importance of disaggregating ethnic/racial groups and depression therapies in understanding and directing efforts to improve depression care in the United States.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Projections of Global Mortality and Burden of Disease from 2002 to 2030
Mathers, C. D., & Loncar, D. (2006) · PLoS Medicine · doi:10.1371/journal.pmed.0030442 · Cited by 11,386 · see citing works
Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?
Andersen, R. M. (1995) · Journal of Health and Social Behavior · doi:10.2307/2137284 · Cited by 9,831 · see citing works
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988 · see citing works
Capps, L. (2003) · JAMA · doi:10.1001/jama.290.18.2487-b · Cited by 4,558 · see citing works
Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B., Klein, D. N., Markowitz, J. C., Ninan, P. T., Kornstein, S., Manber, R., et al. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01866-8 · Cited by 3,829 · see citing works
Linear Mixed Models: A Practical Guide Using Statistical Software
West, B. T., Welch, K. B., & Gałecki, A. T. (2006) · Thammasat University Digital Collections · Cited by 1,392 · see citing works
Self-citationPRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder
Gelenberg, A. J., Freeman, P. B., Markowitz, J. C., Rosenbaum, J. F., Thase, M. E., Trivedi, M. H., & Rhoads, R. S. (2010) · Cited by 1,372 · see citing works
Collaborative Care for Depression: A Cumulative Meta-analysis and Review of Longer-term Outcomes
Gilbody, S. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.21.2314 · Cited by 1,340 · see citing works
Williams, D. R., González, H. M., Neighbors, H. W., Nesse, R. M., Abelson, J. M., Sweetman, J., & Jackson, J. S. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.3.305 · Cited by 1,294 · see citing works
Self-citationHaro, J. M., Arbabzadeh-Bouchez, S., Brugha, T. S., De Girolamo, G., Guyer, M. E., Jin, R., Lepine, J. P., Mazzi, F., Reneses, B., Vilagut, G., et al. (2006) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.196 · Cited by 1,082 · see citing works
The quality of care for depressive and anxiety disorders in the United States
Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001) · Archives of General Psychiatry · doi:10.1001/archpsyc.58.1.55 · Cited by 1,061 · see citing works
Prevalence of Mental Illness in Immigrant and Non-Immigrant U.S. Latino Groups
Alegria, M. M., CANINO, G. J., Shrout, P. E., Woo, M., Duan, N., Vila, D., Torres, M., Chen, C., & Meng, X. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.07040704 · Cited by 1,020 · see citing works
Disparity in Depression Treatment Among Racial and Ethnic Minority Populations in the United States
Alegría, M., Chatterji, P., Wells, K., Cao, Z., Chen, C.-N., Takeuchi, D., Jackson, J., & Meng, X.-L. (2008) · Psychiatric Services · doi:10.1176/ps.2008.59.11.1264 · Cited by 993 · see citing works
Primary Care Physicians Who Treat Blacks and Whites
Bach, P. B., Pham, H. H., Schrag, D., Tate, R. C., & Hargraves, J. L. (2004) · New England Journal of Medicine · doi:10.1056/nejmsa040609 · Cited by 987 · see citing works
Prevalence of psychiatric disorders across Latino subgroups in the United States
Alegría, M., Mulvaney-Day, N., Torres, M., Polo, A., Cao, Z., & Canino, G. (2007) · American Journal of Public Health · doi:10.2105/ajph.2006.087205 · Cited by 816 · see citing works
Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES)
Heeringa, S. G., Wagner, J. R., Torres, M. E., Duan, N., Adams, T., & Berglund, P. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.179 · Cited by 759 · see citing works
Cooper, L. A., Gonzales, J. J., Gallo, J. J., Rost, K. M., Meredith, L. S., Rubenstein, L. V., Wang, N.-Y., & Ford, D. E. (2003) · Medical Care · doi:10.1097/01.mlr.0000053228.58042.e4 · Cited by 651 · see citing works
Kessler, R. C., Abelson, J., Demler, O., Escobar, J. I., Gibbon, M., Guyer, M. E., Howes, M. J., Jin, R., Vega, W. A., Walters, E. E., et al. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.169 · Cited by 489 · see citing works
Self-citationTreatment preferences among depressed primary care patients
Dwight-Johnson, M., Sherbourne, C. D., Liao, D., & Wells, K. B. (2000) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2000.08035.x · Cited by 478 · see citing works
Identification of patient attitudes and preferences regarding treatment of depression
Cooper-Patrick, L., Powe, N. R., Jenckes, M. W., Gonzales, J. J., Levine, D. M., & Ford, D. E. (1997) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1997.00075.x · Cited by 381 · see citing works
Ethnicity and Preferences for Depression Treatment
Givens, J. L., Houston, T. K., Van Voorhees, B. W., Ford, D. E., & Cooper, L. A. (2007) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2006.11.002 · Cited by 330 · see citing works
Depression treatment preferences in older primary care patients
Gum, A. M., Areán, P. A., Hunkeler, E., Tang, L., Katon, W., Hitchcock, P., Steffens, D. C., Dickens, J., & Unützer, J. (2006) · The Gerontologist · doi:10.1093/geront/46.1.14 · Cited by 288 · see citing works
Pennell, B., Bowers, A., Carr, D., Chardoul, S., Cheung, G.-Q., Dinkelmann, K., Gebler, N., Hansen, S. E., Pennell, S., & Torres, M. E. (2004) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.180 · Cited by 284 · see citing works
Assessing the Burden of Disease in the United States Using Disability-Adjusted Life Years
MCKENNA, M., Michaud, C., MURRAY, C., & MARKS, J. (2005) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2005.02.009 · Cited by 273 · see citing works
Katon, W. J., Unützer, J., Fan, M.-Y., Williams, J. W., Schoenbaum, M., Lin, E. H. B., & Hunkeler, E. M. (2006) · Diabetes Care · doi:10.2337/diacare.29.02.06.dc05-1572 · Cited by 259 · see citing works
Perceived Discrimination and Adherence to Medical Care in a Racially Integrated Community
Casagrande, S. S., Gary‐Webb, T. L., LaVeist, T. A., Gaskin, D. J., & Cooper, L. A. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-006-0057-4 · Cited by 244 · see citing works
Disparities in the Adequacy of Depression Treatment in the United States
Harman, J. S., Edlund, M. J., & Fortney, J. C. (2004) · Psychiatric Services · doi:10.1176/appi.ps.55.12.1379 · Cited by 201 · see citing works
Perceived discrimination and reported delay of pharmacy prescriptions and medical tests.
Houtven, C. H. V., Voils, C. I., Oddone, E. Ž., et al. (2005) · PubMed · doi:10.1111/j.1525-1497.2005.0123.x · Cited by 151 · see citing works
Lohr, S. L. (2009) · Handbook of statistics · doi:10.1016/s0169-7161(08)00004-7 · Cited by 139 · see citing works
Williams, D. R., lez, H. M. G. ́., Neighbors, H. W., et al. (2007) · University Libraries (University of Maryland) · doi:10.13016/b2zk-20lu · Cited by 122 · see citing works
Self-citationSeparate and Unequal: Clinics Where Minority and Nonminority Patients Receive Primary Care
Varkey, A. B. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2008.559 · Cited by 112 · see citing works
Prison inmates at midyear 2007
Sasbol, W. J., & Minton, T. D. (2008) · PsycEXTRA Dataset · doi:10.1037/e481382008-001 · Cited by 98 · see citing works
Factors Associated With Noncompliance With Psychiatric Outpatient Visits
Centorrino, F., Hernán, M. A., Drago-Ferrante, G., Rendall, M., Apicella, A., Längar, G., & Baldessarini, R. J. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.3.378 · Cited by 88 · see citing works
Perceived Prejudice in Healthcare and Women's Health Protective Behavior
Facione, N. C., & Facione, P. A. (2007) · Nursing Research · doi:10.1097/01.nnr.0000270026.90359.4c · Cited by 72 · see citing works
Antidepressant Use in Black and White Populations in the United States
González, H. M., Croghan, T. W., West, B. T., Williams, D., Nesse, R. M., Tarraf, W., Taylor, R. J., Hinton, L., Neighbors, H. W., & Jackson, J. S. (2008) · Psychiatric Services · doi:10.1176/appi.ps.59.10.1131 · Cited by 66 · see citing works
Self-citationPrevalence and correlates of dual diagnoses in U.S. Latinos
Vega, W. A., CANINO, G. J., Cao, Z., & Alegria, M. M. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.08.018 · Cited by 55 · see citing works
Self-citationPerception of Racial Barriers to Health Care in the Rural South
Fowler‐Brown, A. G., Ashkin, E., Corbie-Smith, G. M., Thaker, S., & Pathman, D. E. (2006) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2006.0022 · Cited by 52 · see citing works
Alternative healthcare use in the under-served population.
Bazargan, M., Norris, K. C., Bazargan‐Hejazi, S., Akhanjee, L., Calderón, J. L. P., Safvati, S. D., & Baker, R. S. (2005) · PubMed · Cited by 50 · see citing works
Addressing depression treatment preferences of ethnic minority patients
Dwight‐Johnson, M., & Lagomasino, I. T. (2007) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2007.02.001 · Cited by 23 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- [8]Institute of Medicine Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare 2003 The National Academies Press Washington, DC 25032386
- [16]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-1/NP) 1997 Biometrics Research, New York State Psychiatric Institute New York
- [18]Cochran WG Sampling Techniques 1977 Wiley New York, NY 3rd ed.
- [42]Alegría M Chatterji P Wells KB Cao Z Chen CN Takeuchi D Jackson J Meng XL Disparity in depression treatment among racial and ethnic minority populations in the United States Psychiatr Serv 2008 59 11 1264 1272 18971402 PMC2668139
Cited by
Sorted by citations
Barriers to mental health treatment: results from the National Comorbidity Survey Replication
Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., & Kessler, R. C. (2011) · Psychological Medicine · doi:10.1017/s0033291710002291 · Cited by 951 · see citing works
Exercise as a treatment for depression: A meta-analysis
Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.03.063 · Cited by 837 · see citing works
Social media as a measurement tool of depression in populations
De Choudhury, M., Counts, S., & Horvitz, E. (2013) · Proceedings of the 5th Annual ACM Web Science Conference · doi:10.1145/2464464.2464480 · Cited by 497 · see citing works
National trends in the treatment for depression from 1998 to 2007
Marcus, S. C., & Olfson, M. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.151 · Cited by 312 · see citing works
The impact of accommodating client preference in psychotherapy: a meta-analysis
Swift, J. K., Callahan, J. L., Cooper, M., & Parkin, S. R. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22680 · Cited by 279 · see citing works
Shim, R. S., Baltrus, P., Ye, J., & Rust, G. (2011) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2011.01.100121 · Cited by 267 · see citing works
High intelligence: A risk factor for psychological and physiological overexcitabilities
Karpinski, R. I., Kinase Kolb, A. M., Tetreault, N. A., & Borowski, T. B. (2018) · Intelligence · doi:10.1016/j.intell.2017.09.001 · Cited by 217 · see citing works
Reviewing the data security and privacy policies of mobile apps for depression
O'Loughlin, K., Neary, M., Adkins, E. C., & Schueller, S. M. (2019) · Internet Interventions · doi:10.1016/j.invent.2018.12.001 · Cited by 179 · see citing works
Lintvedt, O. K., Griffiths, K. M., Sørensen, K., Østvik, A. R., Wang, C. E. A., Eisemann, M., & Waterloo, K. (2013) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.770 · Cited by 157 · see citing works
Cognitions in bipolar affective disorder and unipolar depression: imagining suicide
Hales, S. A., Deeprose, C., Goodwin, G. M., & Holmes, E. A. (2011) · Bipolar Disorders · doi:10.1111/j.1399-5618.2011.00954.x · Cited by 157 · see citing works
Treating major depression with yoga: A prospective, randomized, controlled pilot trial
Prathikanti, S., Rivera, R., Cochran, A., Tungol, J. G., Fayazmanesh, N., & Weinmann, E. (2017) · PLOS ONE · doi:10.1371/journal.pone.0173869 · Cited by 157 · see citing works
The Economic Burden of Treatment-Resistant Depression
Olchanski, N., McInnis Myers, M., Halseth, M., Cyr, P. L., Bockstedt, L., Goss, T. F., & Howland, R. H. (2013) · Clinical Therapeutics · doi:10.1016/j.clinthera.2012.09.001 · Cited by 146 · see citing works
A randomized controlled trial of internet-based therapy in depression
Moritz, S., Schilling, L., Hauschildt, M., Schröder, J., & Treszl, A. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.04.006 · Cited by 140 · see citing works
Coleman, K. J., Stewart, C., Waitzfelder, B. E., Zeber, J. E., Morales, L. S., Ahmed, A. T., Ahmedani, B. K., Beck, A., Copeland, L. A., Cummings, J. R., et al. (2016) · Psychiatric Services · doi:10.1176/appi.ps.201500217 · Cited by 129 · see citing works
Current research and trends in the use of smartphone applications for mood disorders
Torous, J., & Powell, A. C. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.03.002 · Cited by 121 · see citing works
Religiosity and Mental Health Service Utilization Among African-Americans
Lukachko, A., Myer, I., & Hankerson, S. (2015) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000334 · Cited by 111 · see citing works
Adaptation of the BDI–II in Mexico
González, D. A., Psychology Service, S. T. V. H. C. S. D. O. P., Reséndiz, A., Reyes, I., & de México., U. D. I. P. D. D. I. Y. P. F. D. P. U. N. A. (2015) · Salud mental · doi:10.17711/sm.0185-3325.2015.033 · Cited by 88 · see citing works
Exploring cultural competence in acceptance and commitment therapy outcomes.
Woidneck, M. R., Pratt, K. M., Gundy, J. M., Nelson, C. R., & Twohig, M. P. (2012) · Professional Psychology Research and Practice · doi:10.1037/a0026235 · Cited by 60 · see citing works
Stiles-Shields, C., Montague, E., Kwasny, M. J., & Mohr, D. C. (2019) · Psychological Services · doi:10.1037/ser0000261 · Cited by 59 · see citing works
Moritz, S., Schröder, J., Meyer, B., & Hauschildt, M. (2013) · Depression and Anxiety · doi:10.1002/da.21988 · Cited by 53 · see citing works
Screening for Depression in African-American Churches
Hankerson, S. H., Lee, Y. A., Brawley, D. K., Braswell, K., Wickramaratne, P. J., & Weissman, M. M. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.03.039 · Cited by 49 · see citing works
Pang, Y., Zhang, X., Gao, R., Xu, L., Shen, M., Shi, H., Li, Y., & Li, F. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03396-8 · Cited by 21 · see citing works
Exploring Perceptions and Experiences of Maternal Depression in Latinas: A Qualitative Study
Hayden, M., Connelly, C. D., Baker-Ericzen, M. J., Hazen, A. L., & McCue Horwitz, S. (2013) · Issues in Mental Health Nursing · doi:10.3109/01612840.2012.701708 · Cited by 19 · see citing works
McIntyre, R. S., Prieto, R., Schepman, P., Yeh, Y.-C., Boucher, M., Shelbaya, A., Chambers, R., Gao, X., & Pappadopulos, E. (2019) · Current Medical Research and Opinion · doi:10.1080/03007995.2019.1652053 · Cited by 15 · see citing works
Blended Care Therapy for Depression and Anxiety: Outcomes across Diverse Racial and Ethnic Groups
Owusu, J. T., Wang, P., Wickham, R. E., Cottonham, D. P., Varra, A. A., Chen, C., & Lungu, A. (2023) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-022-01450-z · Cited by 14 · see citing works
Bolge, S. C., Flores, N. M., & Phan, J. H. (2016) · Journal of Occupational & Environmental Medicine · doi:10.1097/jom.0000000000000874 · Cited by 14 · see citing works
Intention to Seek Depression Treatment in Latina Immigrant Mothers
Logsdon, M. C., Morrison, D., Myers, J. A., Capps, J., & Masterson, K. M. (2018) · Issues in Mental Health Nursing · doi:10.1080/01612840.2018.1479905 · Cited by 13 · see citing works
Qiao, J., Sun, Y., Wu, J., & Wang, L. (2019) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2019.7633 · Cited by 8 · see citing works
Attachment and hope as A framework for improving depression outcomes for trauma patients
Blake, J., Leppma, M., Mamboleo, G., Nauser, J., O'Toole, H., & Chan, F. (2020) · Journal of Applied Rehabilitation Counseling · doi:10.1891/jarc-d-19-00005 · Cited by 6 · see citing works
- Authors
- González, H. M., Vega, W. A., Williams, D. R., Tarraf, W., West, B. T., & Neighbors, H. W.
- Affiliations
- Wayne State University (US)
- University of California, Los Angeles (US)
- Harvard University (US)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2010-01-01
- Volume
- 67
- Issue
- 1
- Pages
- 37
- ISSN
- 0003-990X (ISSN-L)
- PMC
- PMC2887749
- OpenAlex
- W2149115787
- Semantic Scholar
- 6f8e33f226f230731cbc4bb4c71c1db04ffd41b0
- Cited by
- 418
- References
- 40
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 9 · 2023: 10 · 2022: 20 · 2021: 22 · 2020: 20 · 2019: 27 · 2018: 26 · 2017: 31 · 2016: 30 · 2015: 33 · 2014: 37 · 2013: 45 · 2012: 39
- FWCI
- 60.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH 67726, MH59575, K08MH067726, R01MH059575, R01MH068804, MH 68804)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- depression care, racial and ethnic disparities, Mexican Americans, African Americans, Puerto Ricans, guideline-concordant treatment, depression pharmacotherapy, major depressive episode, depression severity, Collaborative Psychiatric Epidemiology Surveys
- MeSH terms
- Adolescent, Adult, Antidepressive Agents, Black or African American, Major Depressive Disorder, Depressive Disorder, Major, Ethnicity, Female, Health Services Research, Health Surveys, Humans, Male, Psychotherapy, Severity of Illness Index, United States, Prevalence, Mexican Americans, Caribbean Region, Black People, White People
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
