Study finds gaps in mental health care for Hispanic, Black, Asian children
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Key takeaways:
- Researchers found high odds of unmet treatment among Hispanic and Asian children with anxiety.
- Black children with behavioral problems also had higher odds of unmet treatment.
Hispanic, Black and Asian children have unmet mental health treatment needs compared with their white peers, according to a study in Pediatrics.
“I've been in this space, particularly surrounding culture and mental health, for the past 10 years,” Andrew R. Chang, MMsc, an MD candidate at Harvard Medical School and founder and CEO of the nonprofit Nunchi Health, told Healio. “I built a couple of nonprofits previously in this space, particularly surrounding youth development for racial and ethnic minority members.”
Chang and colleagues were specifically interested in mental health needs from the parents’ perspective, and so they studied data from the National Survey of Children’s Health from 2016 to 2021.
“We did quantitative analysis, particularly using logistic regression in order to identify elevated odds or risks of unmet treatment needs, particularly among racial and ethnic minority groups,” Chang said. “I think the innovative factor that we did was in addition to understanding racial and ethnic disparities and mental health unmet treatment needs. We also disaggregated the treatment needs by the disorders or the problems that the children are presenting with. We disaggregated by for four mental health conditions” — depression, anxiety, behavioral problems and ADHD — “and that sort of allowed us to understand some of the unmet treatment needs, and there are differences by race and ethnicity that are previously masked.”
In total, they analyzed data on 172,107 children aged 3 to 17 years and found higher odds of unmet needs among Hispanic (adjusted OR = 1.41; 95% CI, 1.05-1.9) and Asian (aOR = 2.6; 95% CI, 1.2-4.29) children with anxiety and Black children with behavioral problems (aOR = 1.41; 95% CI, 1-2.02) compared with white children with the same conditions.
One surprise, Chang said, was “just how strong the associations” were in the results.
“In our model, we adjusted for things like insurance status, social economic status,” Chang said. “A lot of the literature has really focused on the idea of stigma, particularly among racial ethnic minority groups, as a deterrent mental health treatment. These data that we collect are coming from the caregivers, who want to see their children receiving care, but somehow our health systems just haven't been able to meet their needs.”
Chang added that it is important for providers “to understand just how to provide culturally aware and culturally humble care.”
“Our investigations further accentuate the need to be mindful in terms of cultural differences in our care,” Chang said. “Quite frankly, I don't think we're serving the needs of racial and ethnic minorities very well, particularly in the mental health space. We’re not addressing some of the things that they really need, particularly with anxiety for Hispanic families and Asian families, and then for behavioral conditions for Black families.”
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