Bridging the divide: advances and challenges in understanding the impact of race and ethnicity on the mental health of older adults.

Abstract

This issue of the American Journal of Geriatric Psychiatry features six articles focusing on aspects of race and ethnicity in the mental health of older adults, ranging from racial-ethnic disparities to culturally informed interventions. This collection illustrates how race and ethnicity are important considerations across psychiatric disorders and neurologic conditions, including depression, schizophrenia, and dementia, as well as factors that cut across diagnoses as traditionally defined (e.g., cognition, perceptions of illness). Addressing racial-ethnic disparities in mental healthcare is a continued challenge in the field of psychiatry. We know African Americans and other underserved minority groups underuse traditional mental health services, compared with white Americans. 1 Identifying culturally relevant health promotion interventions is one approach to engaging older African Americans in utilization of mental health services. Jimenez et al. 2 analyzed data from a randomized depression prevention trial in which 247 adults (154 non-Latino whites, 90 African Americans, 3 Asian) were randomly assigned to either problem-solving therapy or coaching in healthy dietary practices. Participants were age 50 or older who met criteria for subsyndromal depression. African Americans in both conditions had greater improvements in mental healtherelated quality of life compared with non-Latino whites. The authors’ findings shed light on how mental health services can design programs using problemsolving techniques or culturally relevant health promotion interventions (e.g., obesity, which is more prevalent in older African Americans than in older non-Latino whites) to engage older African Americans with subsyndromal depression in mental healthcare. Another strategy for engaging African Americans in mental healthcare involves engagement with local churches. 1 Given the high rate of religious service attendance and the central role of church-based social supports in many African American communities, 1 Chatters et al. 3 examined the influences of church and family informal support networks on depressive symptoms among older African Americans. Crosssectional data were included from 686 African Americans (age 55 years or older) who endorsed attending religious services in the National Survey of American Life. The authors found that social support from church networks were protective against depressive symptoms and psychological distress. A strength of this study was the use of a validated measure to control for the influence of both positive and negative aspects of family support networks. This study contributes to the emerging literature that emotional support from church members is