Racial/Ethnic Disparities in Service Utilization for Individuals With Co-Occurring Mental Health and Substance Use Disorders in the General Population

Abstract BackgroundRacial and ethnic health disparities have been linked with inequalities in access to health care and outcomes. The present study considers whether inequalities persist between racial/ethnic groups among patients with mental health or substance use disorders who visit the emergency department (ED). MethodsWe analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2012-2018, assessing health disparities among patients diagnosed with mental health or substance use disorders by observing whether significant differences exist in ED wait time and length of visit (LOV) for patients of different races/ethnicities. Stratified models were performed to further understand the impact of regions across the U.S., year, and triage level on the association analysis. ResultsFrom 2012-2018, non-Hispanic Black and Hispanic patients experienced significantly longer ED wait times and LOV as compared to White patients. Patients with private insurance experienced significantly shorter wait times compared to patients with self-pay, and shorter LOV than those with Medicaid/ Children’s Health Insurance Program, or Medicare. Male patients had significantly longer LOV compared to female patients. We observed year by year differences in wait times of non-Hispanic Black patients with improvement appearing between the years 2013 to 2016, while LOV remained consistently longer. We observed both regional and triage level differences, with the U.S. Northeast presenting with the most disparities. Additionally, we noted a general upward trend of SUD diagnoses. Conclusion Our analysis suggests that while there has been an overall improvement in median ED wait time through the years, non-Hispanic Black and Hispanic patients experience significantly longer ED wait time compared to non-Hispanic White patients. Additionally, non-Hispanic Black and Hispanic patients have a significantly longer ED LOV compared to non-Hispanic White patients.

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Mental disorders on admission to jail: A study of prevalence and a comparison with a community sample in the north of France

European Psychiatry ◽

10.1192/j.eurpsy.2020.38 ◽

2020 ◽

Vol 63 (1) ◽

Cited By ~ 3

Author(s):

Thomas Fovet ◽

Laurent Plancke ◽

Alina Amariei ◽

Imane Benradia ◽

Fanny Carton ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

General Population ◽

Substance Use Disorders ◽

Prison Population ◽

Community Sample ◽

Prevalence Rates ◽

Psychiatric Interview ◽

Female Prisoners ◽

The North

Abstract Background. The aim of the present study was to estimate prevalence rates of psychiatric and substance use disorders in male and female prisoners on admission to prison in the north of France and compare the frequency of these disorders to the general population. Methods. This cross-sectional survey on Mental Health in the Prison Population (MHPP), conducted between March 2014 and April 2017, interviewed 653 randomly selected men and women who had recently been committed to the French general population prison system in the Nord and Pas-de-Calais departments. For each subject, the Mini International Neuropsychiatric Interview (MINI), a standardized psychiatric interview, was used to screen for psychiatric and substance use disorders. The prevalence rates were then compared with data from the Mental Health in the General Population (MHGP) survey, a general population survey that used the same assessment methodology as MHPP in the Nord and Pas-de-Calais departments. A control sample was taken from the MHGP survey with a ratio of one case (MHPP) to three controls (MHGP) matching on age and sex. Results. The sample was primarily composed of French men, most of them single with low educational levels at the time of imprisonment. The mean age was 31.7 (standard deviation = 9.9; min = 18; max = 67). Most of the subjects included were first-time prisoners. The prevalence of affective disorders among newly incarcerated individuals was 31.2% with higher rates for major depressive disorder (27.2%). The prevalence of anxiety disorders was 44.4% with higher rates for generalized anxiety disorder (25.2%). The prevalence of psychotic syndromes was 6.9%. The prevalence of substance use disorders was 53.5% and a suicide risk was identified in 31.4% of the prisoners interviewed. Higher prevalence rates were found in the MHPP when compared with the MHGP for all psychiatric and substance use disorders assessed except for dysthymia and current isolated psychotic syndrome. Conclusions. Our study shows very high levels of prevalence for psychiatric and substance use disorders in recently committed French prisoners.

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Racial/Ethnic Differences in Contemporaneous Use of Mental Health and Substance Use Treatment Among Individuals Experiencing Both Mental Illness and Substance Use Disorders

Psychiatric Quarterly ◽

10.1007/s11126-016-9444-0 ◽

2016 ◽

Vol 88 (1) ◽

pp. 185-198 ◽

Cited By ~ 6

Author(s):

Eunji Nam ◽

Jason Matejkowski ◽

Sungkyu Lee

Keyword(s):

Mental Health ◽

Mental Illness ◽

Substance Use ◽

Substance Use Disorders ◽

Ethnic Differences ◽

Substance Use Treatment ◽

Racial Ethnic

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Racial/Ethnic Differences in Primary Care Experiences in Patient-Centered Medical Homes among Veterans with Mental Health and Substance Use Disorders

Journal of General Internal Medicine ◽

10.1007/s11606-016-3776-1 ◽

2016 ◽

Vol 31 (12) ◽

pp. 1435-1443 ◽

Cited By ~ 18

Author(s):

Audrey L. Jones ◽

Maria K. Mor ◽

John P. Cashy ◽

Adam J. Gordon ◽

Gretchen L. Haas ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Substance Use ◽

Substance Use Disorders ◽

Ethnic Differences ◽

Patient Centered ◽

Patient Centered Medical Homes ◽

Medical Homes ◽

Racial Ethnic

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Mental health and substance use disorders and treatment receipt among pregnant women in the United States, 2008-2014 : trend analysis, likelihood of treatment receipt, and ethnic disparities in mental health treatment.

10.18297/etd/2775 ◽

2017 ◽

Author(s):

Taghreed Salameh

Keyword(s):

Mental Health ◽

United States ◽

Substance Use ◽

Pregnant Women ◽

Trend Analysis ◽

Substance Use Disorders ◽

Mental Health Treatment ◽

Ethnic Disparities ◽

The United States ◽

Health Treatment

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Epidemiology of Anxiety Disorders in the Australian General Population: Findings of the 2007 Australian National Survey of Mental Health and Wellbeing

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048674.2011.624083 ◽

2011 ◽

Vol 45 (11) ◽

pp. 957-967 ◽

Cited By ~ 124

Author(s):

Peter M. McEvoy ◽

Rachel Grove ◽

Tim Slade

Keyword(s):

Mental Health ◽

Substance Use ◽

Anxiety Disorder ◽

General Population ◽

Anxiety Disorders ◽

Substance Use Disorders ◽

National Survey ◽

Affective Disorders ◽

Lifetime Prevalence ◽

Health And Wellbeing

Objective: The aims of this study were to report 12-month and lifetime prevalence for anxiety disorders in the Australian general population, identify sociodemographic and clinical correlates of anxiety disorders, and report the rates of comorbidity among anxiety, affective, and substance use disorders across the lifespan. Method: The 2007 National Survey of Mental Health and Wellbeing was a nationally representative, face-to-face household survey of 8841 (60% response rate) community residents aged between 16 and 85 years. Diagnoses for anxiety, affective and substance use disorders were made according to the DSM-IV using the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Results: 12-month and lifetime prevalence of anxiety disorders were 11.8% and 20.0%, respectively. Anxiety disorders had a similar median age of onset (19 years) compared to substance use disorders (20 years), but earlier than affective disorders (34 years). Social phobia was the earliest onset anxiety disorder (median 13 years), with generalized anxiety disorder the latest (median 33 years). Significant correlates of the presence of anxiety disorders included being female, single, not in the labour force, in the middle age groups, not having post-graduate qualifications, having a comorbid physical condition, and having a family history of mental disorders. Being in the oldest age ranges and being born in another non-English speaking country were associated with lower odds of having an anxiety disorder. Body mass index was not associated with the presence of an anxiety disorder. Anxiety disorders were highly comorbid, particularly with major depression, dysthymia, and alcohol dependence. Comorbidity with substance use disorders reduced with age. Comorbidity with affective disorders was high across the lifespan. Conclusions: Anxiety disorders are common, can have an early onset, and are highly comorbid. Prevention, early detection, and treatment of anxiety disorders should be a priority.

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