African American service use for mental health problems

The present study examined racial differences in use of mental health services in the specialty mental health and general medical sectors of care. Data came from household and institutional surveys and permitted estimation of services use both in the general population alone and when supplemented with samples of persons confined in jails, prisons, and mental hospitals. In uncontrolled analysis, African Americans in the community presented a mixed pattern of under-, equal-, and overrepresentation in services. Weighting the sample and controlling for sociodemographic differences and diagnoses yielded results indicating that African Americans in the community were consistently less likely than Whites to have sought help. Adding to the analysis persons who were confined eliminated the disparity in the general medical-sector services and reduced the disparity in specialty mental health sector services. Conclusions as to parity and underutilization of mental health services vary with methodological factors linked to adverse social circumstances of African American life. © 1999 John Wiley & Sons, Inc.