Astonishing shortfalls uncovered in depression care

Of the roughly 15.6 million Americans who have major depression, only 21 percent receive minimally adequate care according to a study in the January Archives in General Psychiatry (Vol. 67, No. 1). That number falls precipitously for depressed Mexican-Americans, who receive adequate care 12 percent of the time, and African-Americans, who receive adequate care 14 percent of the time.

The study authors, who defined “adequate care” as at least four visits to a mental health specialist over the course of a year, pulled data from the National Institutes of Health Collaborative Psychiatric Epidemiology Surveys, which asked 15,762 U.S. adults about their mental health and health care from February 2001 to November 2003. For the first time in a national survey, researchers were able to break out Latino participants by country of origin, says study author Hector Gonzalez, PhD, a professor of gerontology, family medicine and public health at Wayne State University in Detroit. The researchers found that while Mexican-Americans lag far behind all Americans in their access to care, Puerto Ricans fared better than average, receiving adequate treatment for depression 24 percent of the time.

“From a public health standpoint, the big question is how to learn from that group,” says Gonzalez. “What are Puerto Ricans doing right that we can apply to reducing disparities across the board?”

—S. Dingfelder