Provider Contributions to Disparities in Mental Health Care.
Psychiatr Serv
; 71(8): 765-771, 2020 08 01.
Article
en En
| MEDLINE
| ID: mdl-32340593
ABSTRACT
OBJECTIVE:
Disparities in diagnosis of mental health problems and in access to treatment among racial-ethnic groups are apparent across different behavioral conditions, particularly in the quality of treatment for depression. This study aimed to determine how much disparities differ across providers.METHODS:
Bayesian mixed-effects models were used to estimate whether disparities in patient adherence to antidepressant medication (N=331,776) or psychotherapy (N=275,095) were associated with specific providers. Models also tested whether providers who achieved greater adherence to treatment, on average, among non-Hispanic white patients than among patients from racial-ethnic minority groups attained lower disparities and whether the percentage of patients from racial-ethnic minority groups in a provider caseload was associated with disparities.RESULTS:
Disparities in adherence to both antidepressant medication and psychotherapy were associated with the provider. Provider performance with non-Hispanic white patients was negatively correlated with provider-specific disparities in adherence to psychotherapy but not to antidepressants. A higher proportion of patients from racial-ethnic minority groups in a provider's caseload was associated with lower adherence among non-Hispanic white patients, lower disparities in adherence to psychotherapy, and greater disparities in adherence to antidepressant medication.CONCLUSIONS:
Adherence to depression treatment among a provider's patients from racial-ethnic minority groups was related to adherence among that provider's non-Hispanic white patients, but evidence also suggested provider-specific disparities. Efforts among providers to decrease disparities might focus on improving the general skill of providers who treat more patients from racial-ethnic minority groups as well as offering culturally based training to providers with notable disparities.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Rol del Médico
/
Psiquiatría
/
Psicología
/
Disparidades en Atención de Salud
/
Trastornos Mentales
/
Servicios de Salud Mental
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Psychiatr Serv
Asunto de la revista:
PSIQUIATRIA
Año:
2020
Tipo del documento:
Article