Racial and ethnic differences in mental health service utilization in suicidal adults: A nationally representative study

Abstract

The current study examined racial/ethnic differences in utilization of mental health services in a nationally representative sample of suicidal adults. Data were extracted from the National Survey on Drug Use and Health (NSDUH) from 2009 to 2016. Participants consisted of adults with severe suicidal ideation and/or behavior in the past 12 months (unweighted n = 17,338). Multivariate logistic regression analyses were conducted to assess racial/ethnic differences in mental health treatment utilization after adjusting for health insurance status, family income, age, sex, and major depression. Analyses were conducted separately for suicidal ideators with no attempts (i. e., “pure” ideators; unweighted n = 14,578) and for suicide attempters (unweighted n = 2760) for psychiatric inpatient and outpatient care, respectively. Racial/ethnic disparities in mental health treatment utilization were less apparent for inpatient care and most evident for outpatient care. For inpatient care, no racial/ethnic differences were observed among suicidal ideators with no attempts. Among suicide attempters, only Hispanics were less likely than non-Hispanic whites to receive inpatient care. In contrast, for outpatient care, treatment use was lower for all racial ethnic minorities, except Native American and multiracial individuals, relative to non-Hispanic whites among suicidal ideators with no attempts. Outpatient service use was also lower for non-Hispanic blacks, Hispanics, and multiracial individuals relative to non-Hispanic whites among suicide attempters. This pattern of findings is consistent with the possibility that suicidal racial/ethnic minorities may delay use of mental health services until clinical severity becomes such that elevated clinical care (i.e., inpatient treatment) is required. Future research accounting for these disparities is warranted.