An article in the November Psychiatric Services reported on nationally representative data from 8,762 people on disparities in access to mental health care. The study found that among the 1,032 people with some depressive disorder, 40 percent of non-Latino white individuals did not access mental health treatment in the previous year, while 64 percent of Latinos, 69 percent of Asians, and 59 percent of African Americans did not do so. African Americans and Asians were especially less likely than non-Latino whites to both have access to care and receive adequate care, wrote Margarita Alegría, Ph.D., who is with the Center for Multicultural Mental Health Research, Cambridge Health Alliance, and Harvard Medical School, and colleagues.

Clinicians may need more help in identifying depression among these groups, they wrote, citing several reasons. For one, minority patients may distrust the medical profession due to prior "mistreatment by mental health professionals." Minority families may also be less likely to recognize and report depression. Latinos and others are more likely to somaticize psychiatric symptoms or use terms like ataques de nervios (which overlaps panic disorder, anxiety disorder, and depression) rather than standard DSM-IV formulations. Stigma and economic factors such as losing half a day's pay to visit a mental health professional also take their toll.

"Simply relying on current systems, without considering the unique barriers to high-quality care that apply for underserved ethnic and racial minority populations, is unlikely to affect the pattern of disparities we observed," concluded Alegría.

"Disparity in Depression Treatment Among Racial and Ethnic Minority Populations in the United States" is posted at<http://ps.psychiatryonline.org/cgi/content/full/59/11/1264>.▪