{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:06:26Z","timestamp":1791615986062,"version":"4.3.4"},"reference-count":40,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH101138"],"award-info":[{"award-number":["R01MH101138"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH115905"],"award-info":[{"award-number":["R01MH115905"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R21MH112055"],"award-info":[{"award-number":["R21MH112055"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["RF1MH120830"],"award-info":[{"award-number":["RF1MH120830"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2023,12,8]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Two decades ago, the Surgeon General issued a report highlighting concerning disparities in mental healthcare among racial and ethnic minority populations. The present study characterised national trends in mental health treatment utilisation by race and ethnicity across a 13-year period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nationally representative data were drawn from the National Survey on Drug Use and Health from 2008 through 2020 (unweighted n=4\u200941\u2009993). Trends in mental health treatment utilisation and perceived unmet treatment need among individuals with and without psychiatric illness were stratified by race and ethnicity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Logistic regression analyses revealed most racial\/ethnic minority groups were less likely to receive treatment than white individuals, regardless of mental health status. Treatment utilisation increased among those with (annual per cent change (APC)=0.83, 95% CI=0.41 to 1.26) and without psychiatric illness (APC=1.39, 95% CI=0.53 to 2.26). Among individuals with psychiatric illness, treatment use increased among white (APC=0.88, 95% CI=0.51 to 1.24), Hispanic (APC=2.12, 95% CI=0.70 to 3.57) and black adults (APC=1.07, 95%\u2009CI=0.11 to 2.04). White (APC=1.88, 95% CI=0.86 to 2.91) and Hispanic (APC=2.45, 95% CI=0.02 to 4.93) individuals without psychiatric illness also saw increased treatment use. Although increases in perceived unmet treatment need were observed for all racial and ethnic groups except blacks and Native Americans with psychiatric illness, rates remained low across all groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Although national rates of mental health treatment utilisation have risen, this was almost entirely observed among white and Hispanic individuals with and without psychiatric illness, highlighting the limited progress made towards eliminating disparities in care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2023-220683","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T13:20:25Z","timestamp":1705670425000},"page":"228-234","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Racial and ethnic trends in mental health service utilisation and perceived unmet need in the USA"],"prefix":"10.1136","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1790-4949","authenticated-orcid":false,"given":"Ana","family":"Sheehan","sequence":"first","affiliation":[{"name":"Department of Psychological, University of Delaware, Newark, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Liu","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Stanley Center for Psychiatric Research, Eli and Edythe L. Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"2025100301004001000_78.4.228.1","unstructured":"Satcher D . Mental health: culture, race, and ethnicity\u2014a supplement to mental health: a report of the surgeon general. US Department of Health and Human Services, 2001."},{"key":"2025100301004001000_78.4.228.2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201500453"},{"key":"2025100301004001000_78.4.228.3","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s00127-017-1400-2","article-title":"Racial\/ethnic differences in perception of need for mental health treatment in a US national sample","volume":"52","author":"Breslau","year":"2017","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"2025100301004001000_78.4.228.4","unstructured":"Anderson KM . How far have we come in reducing health disparities?: Progress since 2000: Workshop summary. National Academies Press, 2012."},{"key":"2025100301004001000_78.4.228.5","unstructured":"Gordon J . The NIMH strategic plan: director\u2019s message. National Institute of Mental Health, 2022. Available: https:\/\/www.nimh.nih.gov\/about\/strategic-planning-reports\/message-from-the-director"},{"key":"2025100301004001000_78.4.228.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2010.07.001"},{"key":"2025100301004001000_78.4.228.7","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.27.2.393"},{"key":"2025100301004001000_78.4.228.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.11.024"},{"key":"2025100301004001000_78.4.228.9","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.20368"},{"key":"2025100301004001000_78.4.228.10","doi-asserted-by":"crossref","first-page":"2062","DOI":"10.1377\/hlthaff.2017.0922","article-title":"National trends in specialty outpatient mental health care among adults","volume":"36","author":"Han","year":"2017","journal-title":"Health Aff (Millwood)"},{"key":"2025100301004001000_78.4.228.11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.21.2581"},{"key":"2025100301004001000_78.4.228.12","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1001\/jamapsychiatry.2018.0623","article-title":"Comparison of early intervention services vs treatment as usual for early-phase psychosis: a systematic review, meta-analysis, and meta-regression","volume":"75","author":"Correll","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"2025100301004001000_78.4.228.13","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.jpsychires.2018.10.019","article-title":"Racial and ethnic differences in mental health service utilization in suicidal adults: a nationally representative study","volume":"107","author":"Sheehan","year":"2018","journal-title":"J Psychiatr Res"},{"key":"2025100301004001000_78.4.228.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61530-5"},{"key":"2025100301004001000_78.4.228.15","doi-asserted-by":"crossref","unstructured":"Kirmayer LJ , Swartz L . Culture and global mental health. In: Global mental health: principles and practice. 2013: 41\u201362.","DOI":"10.1093\/med\/9780199920181.003.0003"},{"key":"2025100301004001000_78.4.228.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.08.011"},{"key":"2025100301004001000_78.4.228.17","doi-asserted-by":"publisher","DOI":"10.1023\/A:1016349624867"},{"key":"2025100301004001000_78.4.228.18","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2000.12088.x"},{"key":"2025100301004001000_78.4.228.19","doi-asserted-by":"publisher","DOI":"10.1023\/A:1021221806912"},{"key":"2025100301004001000_78.4.228.20","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1176\/appi.ps.202100700","article-title":"Trends in racial-ethnic disparities in adult mental health treatment use from 2005 to 2019","volume":"74","author":"Kaur","year":"2023","journal-title":"Psychiatr Serv"},{"key":"2025100301004001000_78.4.228.21","unstructured":"U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral health Statistics and Quality . National survey on drug use and health 2020 (NSDUH-2020-Ds0001). 2021. Available: https:\/\/datafiles.samhsa.gov\/"},{"key":"2025100301004001000_78.4.228.22","unstructured":"Substance Abuse and Mental Health Services Administration . Results from the 2013 National Survey on Drug Use and Health: summary of national findings. NSDUH Series H-48. HHS Publication No(SMA) 14-4863, 2014: 1\u2013143."},{"key":"2025100301004001000_78.4.228.23","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2022.101696","article-title":"National trends of suicidal Ideation and mental health services use among US adults with opioid use disorder, 2009\u20132020","volume":"54","author":"Na","year":"2022","journal-title":"EClinicalMedicine"},{"key":"2025100301004001000_78.4.228.24","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.133.5.859"},{"key":"2025100301004001000_78.4.228.25","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1017\/S0033291720002755","article-title":"National trends in non-fatal suicidal behaviors among adults in the USA from 2009 to 2017","volume":"52","author":"Bornheimer","year":"2022","journal-title":"Psychol Med"},{"key":"2025100301004001000_78.4.228.26","doi-asserted-by":"crossref","first-page":"295","DOI":"10.4088\/JCP.14m09287","article-title":"Prevalence and correlates of past 12-month suicide attempt among adults with past-year suicidal Ideation in the United States","volume":"76","author":"Han","year":"2015","journal-title":"J Clin Psychiatry"},{"key":"2025100301004001000_78.4.228.27","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"2025100301004001000_78.4.228.28","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.psyneuen.2018.03.011","article-title":"Young adults' psychological and physiological reactions to the 2016\u2009U.S. presidential election","volume":"92","author":"Hoyt","year":"2018","journal-title":"Psychoneuroendocrinology"},{"key":"2025100301004001000_78.4.228.29","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1037\/cdp0000301","article-title":"Latino early adolescents\u2019 psychological and physiological responses during the 2016 US presidential election","volume":"26","author":"Zeiders","year":"2020","journal-title":"Cultur Divers Ethnic Minor Psychol"},{"key":"2025100301004001000_78.4.228.30","doi-asserted-by":"crossref","first-page":"113347","DOI":"10.1016\/j.psychres.2020.113347","article-title":"Prevalence of posttraumatic and general psychological stress during COVID-19: a rapid review and meta-analysis","volume":"292","author":"Cooke","year":"2020","journal-title":"Psychiatry Res"},{"key":"2025100301004001000_78.4.228.31","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1176\/appi.ps.202000755","article-title":"Racism and mental health equity: history repeating itself","volume":"72","author":"Mensah","year":"2021","journal-title":"Psychiatr Serv"},{"key":"2025100301004001000_78.4.228.32","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4103\/IJAM.IJAM_49_17","article-title":"The shortage of psychiatrists and other mental health providers: causes, current state, and potential solutions","volume":"3","author":"Butryn","year":"2017","journal-title":"Int J Acad Med"},{"key":"2025100301004001000_78.4.228.33","unstructured":"U.S. Department of Health andHuman Services . National and Regional Projections of Supply and Demand for Surgical Specialty Practitioners: 2013-2025. Bureau of Health Workforce, 2016."},{"key":"2025100301004001000_78.4.228.34","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.6.629"},{"key":"2025100301004001000_78.4.228.35","doi-asserted-by":"publisher","DOI":"10.18865\/ed.29.S2.359"},{"key":"2025100301004001000_78.4.228.36","doi-asserted-by":"crossref","first-page":"99","DOI":"10.17744\/mehc.36.2.480168pxn63g8vkg","article-title":"Integrated health care best practices and culturally and linguistically competent care: practitioner perspectives","volume":"36","author":"Alvarez","year":"2014","journal-title":"J Ment Health Couns"},{"key":"2025100301004001000_78.4.228.37","first-page":"879","article-title":"Beyond misdiagnosis, misunderstanding and mistrust: relevance of the historical perspective in the medical and mental health treatment of people of color","volume":"99","author":"Suite","year":"2007","journal-title":"J Natl Med Assoc"},{"key":"2025100301004001000_78.4.228.38","first-page":"903","article-title":"Improving quality, achieving equity, and increasing diversity in healthcare: the future is now","volume":"6","author":"Betancourt","year":"2013","journal-title":"J Best Pract Health Prof Divers"},{"key":"2025100301004001000_78.4.228.39","doi-asserted-by":"crossref","DOI":"10.1016\/j.cpr.2021.102063","article-title":"The effectiveness of adapted psychological interventions for people from ethnic minority groups: a systematic review and conceptual typology","volume":"88","author":"Arundell","year":"2021","journal-title":"Clin Psychol Rev"},{"key":"2025100301004001000_78.4.228.40","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.172"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2023-220683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:00:53Z","timestamp":1759478453000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2023-220683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,3,8]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/jech-2023-220683"],"URL":"https:\/\/doi.org\/10.1136\/jech-2023-220683","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,19]]}}}