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December 17, 1999

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African-Americans More Likely To Get Counseling From General Health Providers

The greatest increase in the use of mental health services during the past decade has been among African-Americans in general primary care settings, according to a Johns Hopkins study of Baltimore residents.

The study, part of a National Institute of Mental Health (NIMH) initiative to measure the amount of psychiatric disorders in the general population, surveyed and compared the use of mental health services among 1,662 East Baltimore residents in 1981 and 1993. People were questioned about income, education, age, psychiatric distress, physical health and the use of health services.

In 1981, African-Americans were 40 percent less likely than whites to receive any mental health services. In 1993, there was no observed difference between African-Americans and whites in the reported direct use of mental health services. But, a higher proportion of African-Americans (14.9 percent) than whites (10.8 percent) reported getting mental health services in general medical settings, without seeing a mental health specialist. Study results were published in the October issue of the journal Medical Care.

"African-Americans may be more likely to discuss mental health concerns with general medical providers than with mental health specialists for several reasons," says Lisa Cooper-Patrick, M.D., M.P.H., lead author of the study and assistant professor of medicine. "Previous research has shown that they tend to have more fears related to mental health treatment and a mistrust of mental health professionals. They also are more likely to focus on physical complaints and to have better rapport with primary care providers."

Mental health service use was defined as talking to any health professional about an emotional, nervous, drug or alcohol problem within the six months preceding the survey. During the time spread, psychiatric distress overall increased from 14 percent to 20 percent. An increase was seen among all age groups, with the most dramatic climb among those who were at least 65 years old in 1981.

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