Differences in Mental Health Symptoms and Inequities in Mental Health Service Use Among Black and White Populations and Asian and Latine Subpopulations

Background: While studies have observed mental health inequities across aggregated Asian and Latine populations, a critical gap exists in our understanding of inequities within and across Asian and Latine subpopulations.

Objective: We examined the prevalence of mental health symptoms and variations in mental health service use across Black and White populations and Asian and Latine subpopulations at a more granular level.

Methods: We conducted a cross-sectional study using data from the 2016-2021 Medical Expenditure Panel Survey. Outcomes included mental health symptoms (mild and serious) and mental health service use (outpatient mental health visits and psychotropic medication fills). The primary independent variable was the category of 13 racial/ethnic groups: Black and non-Latine White individuals and Asian (Asian Indian, Chinese, Filipino, and Other Asian) and Latine (Central/South American, Cuban, Dominican, Mexican, Other Latine, and Puerto Rican) subpopulation individuals.

Results: We found modest differences in mental health symptoms by race/ethnicity. However, significant differences were observed in mental health service use among individuals with mental health symptoms. These differences were pronounced across Asian subpopulations with serious mental health symptoms. The likelihood of having any outpatient mental health visit was lower among Asian Indian (- 12.2 percentage points [95% CI - 18.2, - 6.2], Chinese (- 11.7 [- 21.6, - 1.7]), and Filipino individuals (- 16.1 [- 22.5, - 9.8]) than White individuals. The likelihood of having psychotropic medication fill was lower among Asian Indian (- 23.3 [- 34, - 12.7]), Chinese (- 19.8 [- 30.7, - 8.9]), Filipino (- 27.6 [- 40.2, - 14.9]), and other Asian individuals (- 22.5 [- 29.4, - 15.6]) than White individuals. On the other hand, some of these differences were observed in certain Latine subpopulations but not in others.

Conclusions: There is a heterogeneity in inequities in mental health service use among Asian and Latine subpopulation groups. These findings underscore the importance of studying granular categories of race/ethnicity for targeting mental health inequities.