Racial/Ethnic Disparities in Service Utilization for Individuals With Co-Occurring Mental Health and Substance Use Disorders in the General Population: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
Mark L. Hatzenbuehler, MS, MPhil; Katherine M. Keyes, MPH; William E. Narrow, MD, MPH; Bridget F. Grant, PhD, PhD; and Deborah S. Hasin, PhD
J Clin Psychiatry 2008;69(7):1112-1121
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: This study sought to
determine whether black/white disparities in service
utilization for mental health and substance use
disorders persist or are diminished among individuals
with psychiatric comorbidity in the general population.
Method: The 2001-2002 National
Epidemiologic Survey on Alcohol and Related
Conditions was used to identify individuals
with lifetime co-occurring substance use disorders and
mood/anxiety disorders (N = 4250; whites, N =
3597; blacks, N = 653). Lifetime service utilization
for problems with mood, anxiety, alcohol, and
drugs was assessed.
Results: Compared to
whites, blacks with co-occurring mood or anxiety and substance use
disorders were significantly less likely to
receive services for mood or anxiety disorders,
equally likely to receive services for alcohol use
disorders, and more likely to receive some types
of services for drug use disorders. Regardless of race/ethnicity, individuals with these
co-occurring disorders were almost twice as likely to use
services for mood/anxiety disorders than for substance use disorders.
Conclusion: Despite the fact that
comorbidity generally increases the likelihood of service
use, black/white disparities in service
utilization among an all-comorbid sample were found,
although these disparities differed by type of
disorder. Further research is warranted to
understand the factors underlying these differences.
Prevention and intervention strategies are needed to
address the specific mental health needs of blacks with co-occurring disorders, as well as the
overall lack of service use for substance use
disorders among individuals with co-occurring
psychiatric conditions.