Psychiatr Q (2006) 77:211–222
Gender and Racial/Ethnic Differences in Use
of Outpatient Mental Health and Substance
Use Services by Depressed Adults
Victoria D. Ojeda, Ph.D., M.P.H. ·
Thomas G. McGuire, Ph.D.
Published online: 23 August 2006
Springer Science+Business Media, Inc. 2006
Abstract This study examines depressed adults’ use of mental health services, focusing on
Latinos and African Americans. Self-report data for adults meeting CIDI criteria for major de-
pression or dysthymia from the 1997–98 HealthCare for Communities Survey were analyzed.
Gender stratiﬁed logistic regression models examined the relationship between race/ethnicity
and outpatient mental health service use, controlling for sociodemographic, health status,
insurance, and geographic characteristics. Latinas and African American women and men
exhibited low use of outpatient mental health services. Similar results were observed in
an insured subsample. Service use by minorities was more affected by ﬁnancial and social
barriers (e.g., stigma). No gender differences were observed in self-reported barriers to care.
Concerted and continued efforts to promote access to mental health services are critical for
minority men and women affected by depression; adults may have unmet mental health
needs. Other vulnerable populations include older adults especially, men, and men in poor
Mental health services
Access to care
Depression is one of the most commonly diagnosed mental health conditions and prevalence
rates vary by gender and race/ethnicity. Recent estimates from the National Comorbidity
Survey Replication reveal a lifetime prevalence of Major Depressive Disorder (MDD) of
16.2% and a 12-month prevalence rate of 6.6% in the general population . Depression is
more common among women than men. Women’s rates of MDD are frequently 1.5 times to
3 times those of men. Similar patterns are observed for dysthymia [1, 2]. African Americans
V. D. Ojeda, Ph.D., M.P.H. (
) · T. G. McGuire, Ph.D.
Department of Health Care Policy, Harvard Medical School,
180 Longwood Ave, Boston, MA 02115, USA