February 22, 2012

Blacks with Higher Education Less Likely to Seek Mental Health Services, Particularly if They Have Previous Treatment Experience

Stigma, lack of trust remain barriers

WASHINGTON—Young adult blacks, especially those with higher levels of education, are significantly less likely to seek mental health services than their white counterparts, according to a study published by the American Psychological Association.

“Past research has indicated people with higher education levels are more likely to seek out and receive mental health services. While that may be true for whites, it appears the opposite is true for young adult blacks,” said study author Clifford L. Broman, PhD, of Michigan State University. Broman’s article was published in the February issue of APA’s journal Psychological Services.

Stigma, lack of knowledge, trust and cultural understanding were key barriers to using mental health services, according to previous research with focus groups of blacks, Broman said.

The study examined two sets of data -- one collected in 1994 and 1995 that consisted of 6,504 adolescents ages 13-18, and a second set collected in 2001, with 4,881 adults ages 18-26. The data came from the National Longitudinal Study of Adolescent Health, conducted by the Carolina Population Center at the University of North Carolina at Chapel Hill, which used a nationally representative sample.

The analysis also found that while whites who have previously used mental health services were more likely to receive additional services, the opposite was true for blacks. Previous research suggests that blacks receive a lower quality of care when using mental health services and they report unpleasant experiences and unfavorable attitudes after receiving care, the study noted.

“Practitioners need to address the concerns of black clients in a culturally sensitive and appropriate manner, and during exit interviews, they should ask what is appropriate and what didn’t work,” Broman said.

Contrary to previous research findings, the study revealed that the need for professional mental health services and not demographics may be the most important factor associated with whether a young adult of any race uses the services. While almost all previous research has found women use mental health services more often than men, the current study found no general differences between men and women in use of mental health services when the researchers controlled for depression, both clinically diagnosed and self-reported. Likewise, black young adults who had been diagnosed with depression were more than 20 times more likely to use mental health services than those without a diagnosis of depression.

A limitation of the research was that the data did not specifically define “mental health provider;” therefore, respondents could have been referring to receiving mental health services from a medical doctor, religious leader or a specialty mental health provider, the article said.

Article: “Race Differences in the Receipt of Mental Health Services Among Young Adults,” Clifford L. Broman, PhD, Michigan State University; Psychological Services, Vol. 9, No. 1.

Dr. Clifford L. Broman can be contacted by phone at (517) 355-1761 or by email.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 154,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.