Racial and Ethnic Disparities in the Diagnosis and Treatment of Behavioral Health Disorders

CCBH Presents: In 2001, the Surgeon General’s supplement report “ Mental Health: Culture, Race, and Ethnicity” documented the disparities for racial and ethnic minorities in mental health and mental health care and set the foundation needed to understand the impact on health outcomes. Nearly 25 years later disparities in diagnosis and treatment for a range of behavioral disorders including schizophrenia and psychosis, depression, and attention deficit hyperactivity disorder (ADHD) substance use disorders persist and adversely affect disadvantaged populations. Societal biases, institutional and interpersonal racism, clinician biases in interpretation of symptoms, unequal access to care, and shortages of health care in underserved communities have been identified as factors contributing to these disparities. The impact of social determinants of health (SDOH) on attribution of psychiatric diagnosis and receipt of treatment has been recognized.

In this presentation we will 1). review historical and recent findings on the racial and ethnic disparities in diagnosis and treatment of behavioral health disorders including psychotic disorders; depressive disorders, substance use disorder, and attention deficit hyperactivity disorder; 2) share deidentified aggregate Community Care data regarding differences in the rates of diagnosis of psychotic disorders across race and ethnicity as well as differences in adherence to antipsychotic medication for members with serious and persistent mental illness; 3). Discuss how diagnostic overshadowing and other factors contribute to diagnostic and treatment disparities; 4). Review the link between Social Determinants of Health (SDOH) and mental health disorders; and 5). Discuss how clinician awareness of contributing factors to diagnostic and treatment disparities can improve clinical decision making and enhance outcomes for members.

Learning Objectives:
1. Summarize recent findings of racial and ethnic disparities in the diagnosis and treatment of psychosis and one other mental health disorder.
2. Identify the methodological differences across studies that impact reported rates of ADHD diagnosis and treatment.
3. Give examples how diagnostic overshadowing contributes to health disparities.
4. Explain the link between Social Determinants of Health (SDOH) behavioral health disorders.

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