Chartbook for Hispanic Health Care

• Thirty years ago, the Heckler Report found that:
  • National data are not available for homicide deaths among Hispanic populations, but data from the five-State southwestern region, where more than 60% of Hispanics reside, show that from 1976 to 1980, the homicide rate was 21.6 per 100,000, more than 2.5 times the rate of the White population (7.7 per 100,000) in the same geographic area.

Mental Health Care for Hispanics

• Trends: No measure of mental health care for Hispanics was improving; suicide deaths were increasing.
• Groups With Disparities:
  • Hispanic adults were less likely than White adults to receive mental health treatment or counseling and this disparity was not changing over time.
  • When experiencing a major depressive episode, Hispanic adults and adolescents were less likely than Whites to receive treatment. These disparities were not changing over time.
  • Hispanics had lower suicide death rates than Whites, but this disparity was narrowing as Hispanic suicide deaths increased.

Treatment for Depression: Adults

Adults with a major depressive episode in the past year who received treatment for depression in the past year, by race/ethnicity, 2008-2012

Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2008-2012.
Denominator: Adults age 18 and over with a major depressive episode in the past year.
Note: Major depressive episode is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of the symptoms of depression described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Treatment for depression is defined as seeing or talking to a medical doctor or other professional or using prescription medication in the past year for depression.

• Importance: The United States Preventive Services Task Force (USPSTF) recommends screening adults for depression when staff-assisted depression care supports are in place to ensure accurate diagnosis, effective treatment, and followup (USPSTF, 2009ⁱ).
• Overall Rate: In 2012, 68% of adults with a major depressive episode received treatment for depression.
• Groups With Disparities:
  • In all years, Black adults with depression were less likely than White adults to receive treatment.
  • In every year except 2010, Hispanic adults with depression were less likely than White adults to receive treatment.

Treatment for Depression: Adolescents

Adolescents with a major depressive episode in the past year who received treatment for depression in the past year, by race/ethnicity, 2008-2012

Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2008-2012.
Denominator: Adolescents ages 12-17 with a major depressive episode in the past year.
Note: Major depressive episode is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of the symptoms of depression described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. Treatment for depression is defined as seeing or talking to a medical doctor or other professional or using prescription medication in the past year for depression.

• Importance:
  • Outpatient mental health treatment and psychotropic medication use in children and adolescents increased in the United States between 1996-1998 and 2010-2012. Although youths with less severe or no impairment accounted for most of the absolute increase in service use, youths with more severe impairment had the greatest relative increase in use, yet less than half accessed services in 2010-2012 (Olfson, et al., 2015ⁱⁱ).
  • The United States Preventive Services Task Force (USPSTF) recommends screening of adolescents ages 12-18 years for major depressive disorder when systems are in place to ensure accurate diagnosis, psychotherapy (cognitive-behavioral or interpersonal), and followup (USPSTF, 2015ⁱⁱⁱ).
• Overall Rate: In 2012, 37% of adolescents with a major depressive episode received treatment for depression.
• Groups With Disparities: In 2012, Hispanic adolescents with depression were less likely than White adolescents to receive treatment.

AHRQ Health Care Innovations in Mental Health Care

University of Southern California

• Population: Low-income Hispanic patients with diabetes.
• Location: Los Angeles, California.
• Intervention: Worked with two safety net clinics to offer a socioculturally tailored program to treat depression.
• Outcomes: Improved long-term adherence to antidepressant medication, reduced depression-related symptoms, and increased patient satisfaction with depression care.

^i. Depression in adults: screening. Released December 2009. Current as of July 2015. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-adults-screening?ds=1&s=depression.

^ii. Olfson M1, Druss BG, Marcus SC. Trends in mental health care among children and adolescents. N Engl J Med 2015 May 21;372(21):2029-38.

^iii. Depression in children and adolescents: screening. Released December 2009. Current as of July 2015. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/depression-in-children-and-adolescents-screening?ds=1&s=depression.

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