Citation

Lee-Tauler SY, Eun J, Corbett D, Collins PY. Psychiatr. Serv. 2018; 69(6): 628-647.

Affiliation

Dr. Lee-Tauler is with the Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and the Johns Hopkins University Bloomberg School of Public Health, Baltimore. Mr. Eun is with the Feinstein Institute for Medical Research, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York. Ms. Corbett is with the Office of Extramural Research, National Institutes of Health, Bethesda. Dr. Collins is with the Department of Psychiatry and Behavioral Sciences and the Department of Global Health, University of Washington, Seattle. At the time that this work was carried out, Dr. Lee-Tauler, Ms. Corbett, and Dr. Collins were with the Office for Research on Disparities and Global Mental Health, National Institute of Mental Health, Bethesda.

Copyright

(Copyright © 2018, American Psychiatric Association)

DOI

10.1176/appi.ps.201700382

PMID

29716446

Abstract

OBJECTIVE: The objective of this systematic review was to identify interventions to improve the initiation of mental health care among racial-ethnic minority groups.

METHODS: The authors searched three electronic databases in February 2016 and independently assessed eligibility of 2,065 titles and abstracts on the basis of three criteria: the study design included an intervention, the participants were members of racial-ethnic minority groups and lived in the United States, and the outcome measures included initial access to or attitudes toward mental health care. The qualitative synthesis involved 29 studies.

RESULTS: Interventions identified included collaborative care (N=10), psychoeducation (N=7), case management (N=5), colocation of mental health services within existing services (N=4), screening and referral (N=2), and a change in Medicare medication reimbursement policy that served as a natural experiment (N=1). Reduction of disparities in the initiation of antidepressants or psychotherapy was noted in seven interventions (four involving collaborative care, two involving colocation of mental health services, and one involving screening and referral). Five of these disparities-reducing interventions were tested among older adults only. Most (N=23) interventions incorporated adaptations designed to address social or cultural barriers to care.

CONCLUSIONS: Interventions that used a model of integrated care reduced racial-ethnic disparities in the initiation of mental health care.

Language: en

Keywords

Attitudes toward mental illness; Disparities in mental health care; Racial-ethnic minority groups; Research/service delivery; Service delivery systems