Mental Health Economics and African Americans Darrell J. Gaskin, PhD Associate Professor and Acting Chair African American Studies Department University of Maryland, College Park Research Associate Hopkins Center for Health Disparities Solutions

Acknowledgements Dr. De Lois Powell, Project Manager Mr. Pierre E. Wright, Director United Negro College Fund Special Programs Corporation National Library of Medicine

Are there race disparities in mental health? African Americans have lower rates of mental disorders than whites. ECA - 1980s sample from Baltimore, St. Louis, Durham-Piedmont, LA and New Haven NCS - nationally representative sample of 666 African Americans, 4498 Whites

Lifetime Prevalence of Selected Mental Disorder for Blacks and Whites from ECA

Lifetime Prevalence of Selected Mental Disorder for Blacks and Whites from NCS

Race Differences in Self Reported Mental Disorders However, African Americans compared to White are more likely to report they suffer from seriously psychological distress. Based on the K6 – Sadness, Nervousness, Restless, Hopeless, Everything an effort, Worthless over the past 30 days (Kessler et al 2003).

Percent of Adults Who Reported They Suffer from Serious Psychological Distress, by Race 2004-2005 Source: OMH website and CDC, 2007. Health United States, 2007. Table 61

Percent of Adults Who Reported They Suffer from Aspects of Serious Psychological Distress, by Race 2004-2005 Source: OMH website and CDC, 2007. Summary Health Statistics for U.S. Adults: 2006. Table 14.

Relationship between Race and Serious Psychological Distress Is Related to Poverty Status, 2004-2005 Source: OMH website and CDC, 2007. Summary Health Statistics for U.S. Adults: 2006. Table 14.

Disparities in Mental Healthcare Use African Americans are less likely to use mental health services. African Americans are more likely to depend on primary care physician and safety net providers instead of mental health specialists for care. African Americans receive lower quality care.

Disparities in Treatment for Mental Health Problems, by Race Source: OMH website and 2006 National Healthcare Disparities Report. Table 229b & 231b (2005) Health United States, 2007. Data table for Figure 36 (1999-2002).

Percent of Adults With Major Depressive Episode Who Received Treatment for Depression, by Race 2004 Source: OMH website and 2006 National Healthcare Disparities Report. Table 93b.

Why are there Disparities in Mental Healthcare Use? Provider/Prejudice Bias Diagnosis Bias Stigma Patient Preferences Mistrust Poor Communication Residential Segregation/Geographic Barriers High Rates of Poverty Lack of Health Insurance

African Americans and Hispanics Are Most Likely to Be Uninsured Source: Table 6 CPS P60-233

Poverty Status by Race/Ethnicity Source: Table 6 CPS P60-233

Mental illness is costly Creates job-related problems Lower productivity Absenteeism Lowers quality of life Creates problem for children Academic failure Peer rejection

Contact Information Darrell J. Gaskin, PhD Associate Professor of Health Economics Acting Chair, African American Studies Department College of Behavioral and Social Sciences University of Maryland 2169 LeFrak Hall College Park, Maryland 20742 301-405-1162 (phone) 301-314-9932 (fax) dgaskin@aasp.umd.edu