Objective

To examine trends in mental health care use for Black and Latinx children and adolescents.

Method

Data from the Medical Expenditure Panel Survey for 2010-2017 were analyzed to assess trends among youth ages 5-17 in use and expenditures for any mental health care, outpatient mental health care, and psychotropic medication prescription fills. Unadjusted trends for all youth and the subpopulation of youth reporting need for mental health care and disparities adjusting for need were examined.

Results

Between 2010 and 2017, Black youth rates of any past year mental health care use decreased (from 9% to 8%), while White (from 13% to 15%) and Latinx (from 6% to 8%) youth rates increased. Among the subpopulation with need and in regression analysis adjusting for need, we identified significant Black–White and Latinx–White disparities in any mental health care use and any outpatient mental health care use in 2010-2011 and 2016-2017, with significant worsening of Black–White disparities over time. White youth were more than twice as likely as Latinx youth to use psychotropic medications, and Latinx–White and Black–White disparities in psychotropic medication prescription fills persisted over time. Black–White disparities existed in overall mental health expenditures (2016-2017) and outpatient mental health expenditures (2010-2011 and 2016-2017).

Conclusion

Affordable, ubiquitous access to mental health care for Black and Latinx youth remains an elusive target. Significant disparities exist in receiving mental health care despite reforms and policies designed to increase mental health care access in the general population. Additional outreach and treatment strategies tailored to the cultural, linguistic, and structural needs of youth of color are required.

中文翻译：

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2010-2017 年儿童精神卫生保健获取和支出的种族/民族差异趋势：尽管进行了彻底的政策改革，但差距仍然存在

客观的

研究黑人和拉丁裔儿童和青少年心理保健使用的趋势。

方法

对 2010-2017 年医疗支出小组调查的数据进行了分析，以评估 5-17 岁青少年在任何精神卫生保健、门诊精神卫生保健和精神药物处方配药方面的使用和支出趋势。研究了所有青年和报告精神卫生保健需求的青年亚群体的未经调整的趋势以及根据需求进行调整的差异。

结果

2010 年至 2017 年间，黑人青少年在过去一年中使用精神卫生保健的比率有所下降（从 9% 至 8%），而白人（从 13% 至 15%）和拉丁裔（从 6% 至 8%）青少年的比率有所上升。在有需求的亚人群中以及根据需求进行回归分析中，我们发现 2010-2011 年和 2016-2017 年任何精神卫生保健使用和任何门诊精神卫生保健使用都存在显着的黑人-白人和拉丁裔-白人差异，其中随着时间的推移，黑白差异。白人青少年使用精神药物的可能性是拉丁裔青少年的两倍多，而且随着时间的推移，拉丁裔与白人和黑人与白人在精神药物处方方面的差异持续存在。总体精神卫生支出（2016-2017年）和门诊精神卫生支出（2010-2011年和2016-2017年）存在黑人与白人之间的差异。

结论

为黑人和拉丁裔青年提供负担得起的、无处不在的心理保健服务仍然是一个难以实现的目标。尽管进行了旨在增加普通民众获得精神卫生保健服务的改革和政策，但在接受精神卫生保健方面仍存在显着差异。需要针对有色人种青年的文化、语言和结构需求制定额外的外展和治疗策略。