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Cited by 66Mental Health Treatment and AccessRacial and Ethnic Identity ResearchHealth disparities and outcomes

Racial-ethnic disparities in outpatient mental health care in the United States

Open access
Olfson, Mark, Zuvekas, Samuel H., McClellan, Chandler, Wall, Melanie M., Hankerson, Sidney H., Blanco, Carlos·2023·Psychiatric Services
DOI 10.1176/appi.ps.20220365
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Abstract

OBJECTIVE: The authors aimed to compare national rates and patterns of use of outpatient mental health care among Hispanic, non-Hispanic Black, and non-Hispanic White individuals. METHODS: Data from the 2018-2019 Medical Expenditure Panel Survey, a nationally representative survey of U.S. households, were analyzed, focusing on use of any outpatient mental health care service by non-Hispanic White (N=29,126), non-Hispanic Black (N=7,965), and Hispanic (N=12,640) individuals ages ≥4 years (N=49,731). Among individuals using any mental health care, analyses focused on those using psychotropic medications, psychotherapy, or both and on receipt of minimally adequate mental health care. RESULTS: The annual rate per 100 persons of any outpatient mental health service use was more than twice as high for White (25.3) individuals as for Black (12.2) or Hispanic (11.4) individuals. Among those receiving outpatient mental health care, Black (69.9%) and Hispanic (68.4%) patients were significantly less likely than White (83.4%) patients to receive psychotropic medications, but Black (47.7%) and Hispanic (42.6%) patients were significantly more likely than White (33.3%) patients to receive psychotherapy. Among those treated for depression, anxiety, attention-deficit hyperactivity disorder, or disruptive behavior disorders, no significant differences were found in the proportions of White, Black, or Hispanic patients who received minimally adequate treatment. CONCLUSIONS: Large racial-ethnic gaps in any mental health service use and smaller differences in patterns of treatment suggest that achieving racial-ethnic equity in outpatient mental health care delivery will require dedicated efforts to promote greater mental health service access for Black and Hispanic persons in need.

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  • People with limited resources and racial/ethnic minority individuals often face socioecological barriers-such as unequal healthcare access and mental health stigma-that reduce their use of psychosocial resources.

    “Individuals with limited resources and those from racial and ethnic minority groups (eg, Black, Hispanic) often have socioecological factors, such as disparities in healthcare access and mental health stigma, that impede their use of psychosocial resources.14–17”

    From Culturally Informed Digital Behavioral Intervention Development for Inflammatory Bowel Disease: A Qualitative Study (2025) · cites this paper as [15]

    The Discussion reports that socioeconomic disadvantages restrict mental health care options for Black and Hispanic patients, and the Conclusions describe substantial racial-ethnic gaps in service access. The paper does not specifically identify mental health stigma as a barrier or establish reduced use of psychosocial resources broadly; it examines outpatient mental health care. (LLM, conf=0.86)

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  • Mental health care is marked by racial and ethnic disparities: Hispanic and non-Hispanic Black patients receive less care than White patients.

    “Racial and ethnic disparities in mental health care exist, with Hispanic and non-Hispanic Black patients receiving less mental health care compared to White patients.15”

    From Culturally Informed Digital Behavioral Intervention Development for Inflammatory Bowel Disease: A Qualitative Study (2025) · cites this paper as [15]

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Authors
Olfson, M., Zuvekas, S. H., McClellan, C., Wall, M. M., Hankerson, S. H., & Blanco, C.
Affiliations
National Institute on Drug Abuse (US)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2023-07-01
Volume
74
Issue
7
Pages
674-683
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.20220365
OpenAlex
W4313488503
Cited by
66
References
45
Citations by year
2026: 22 · 2025: 26 · 2024: 12 · 2023: 6
FWCI
19.49
Type
journal article
Language
en
Open access
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Social Sciences › Health › Health disparities and outcomes
Keywords
racial and ethnic disparities, outpatient psychiatric care, mental health service utilization, Hispanic individuals, non-Hispanic blacks, psychotropic drugs, psychotherapy, access to mental health care, depression, anxiety, attention deficit hyperactivity disorder, disruptive behavior disorders
MeSH terms
White, Black or African American, Ethnicity, Hispanic or Latino, Humans, Mental Health, Mental Health Services, Outpatients, Psychotropic Drugs, United States, Racial Groups, Healthcare Disparities

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