Provided by David Satcher, M.D., Ph.D.
Surgeon General of the United States of America
Chapter 2
Overview of Cultural Diversity and Mental Health Services
Epidemiology and Utilization of Services
One of the best ways to identify whether a minority group has problems accessing
mental health services is to examine their utilization of services in relation
to their need for services. As noted previously, a limitation of contemporary
mental health knowledge is the lack of standard measures of “need for treatment”
and culturally appropriate assessment tools. Minority group members’ needs, as
measured indirectly by their prevalence of mental illness in relation to the
U.S. population, should be proportional to their utilization, as measured by
their representation in the treatment population. These comparisons turn out to
be exceedingly complicated by inadequate understanding of the prevalence of
mental disorders among minority groups in the United States.24 Nationwide
studies conducted many years ago overlooked institutional populations, which are
disproportionately represented by minority groups. Treatment utilization
information on minority groups in relation to whites is more plentiful, yet, a
clear understanding of health seeking behavior in various cultures is lacking.
The following paragraphs reveal that disparities abound in treatment
utilization: some minority groups are underrepresented in the outpatient
treatment population while, at the same time, overrepresented in the inpatient
population. Possible explanations for the differences in utilization are
discussed in a later section.
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