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Chartbook on Health Care for Blacks

Part 2: Trends in Priorities of the Heckler Report—Suicide Prevention and Mental Health Care

Mental Health Care for Blacks

Measure Most Recent Disparity Disparity Change
Adults with a major depressive episode in the last 12 months who received treatment Same No Change
Adolescents ages 12-17 with a major depressive episode in the last 12 months who received treatment Worse No Change
Suicide deaths per 100,000 population Better Narrowing
  • Trends: The percentage of adults with major depressive episode who received treatment improved.
  • Groups With Disparities:
    • The percentage of adults who received treatment for depression was the same for Blacks and Whites and this disparity did not change over time.
    • The percentage of adolescents who received treatment for depression was lower for Blacks than for Whites and this disparity did not change over time.
    • Blacks had a lower suicide death rate than Whites but this disparity is narrowing as Black suicide deaths increased.

Adults Who Received Treatment for Depression

Adults with a major depressive episode in the past year who received treatment for depression in the past year, by race, 2008-2013

Chart shows adults with a major depressive episode in the past year who received treatment for depression in the past year. Text description is below the image.

Race 2008 2009 2010 2011 2012 2013
Total 68.3 64.4 68.2 68.1 68.0 68.6
White 70.4 66.1 70.8 70.9 69.3 70.2
Black 56.0 53.1 55.7 54.9 61.0 62.3

Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2008-2013.
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 for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate followup (USPSTF, 2016).
  • Overall Rate: In 2013, 68.6% of adults with a major depressive episode received treatment for depression.
  • Groups With Disparities: From 2008 to 2012, Black adults with depression were less likely than White adults to receive treatment. In 2013, this disparity was no longer statistically significant.

Adolescents Who Received Treatment for Depression

Adolescents with a major depressive episode in the past year who received treatment for depression in the past year, by race, 2008-2013

Chart shows adolescents with a major depressive episode in the past year who received treatment for depression in the past year. Text description is below the image.

Race 2008 2009 2010 2011 2012 2013
Total 37.7 34.7 37.8 38.4 37.0 38.1
White 40.8 36.6 40.5 38.7 37.8 40.2
Black 31.8 26.6 24.3 40.1 32.6 30.8

Source: Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2008-2013.
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., 2015).
    • 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, 2016).
  • Overall Rate: In 2013, 38.1% of adolescents with a major depressive episode (MDE) received treatment for depression.
  • Trends: From 2008 to 2013, there were no statistically significant changes over time overall, for Blacks, or for Whites in the percentage of adolescents receiving treatment for depression.
  • Groups With Disparities: In all years except 2011 and 2012, Black adolescents were less likely to receive needed treatment for MDE than Whites. In 2013, 30.8% of Black adolescents with MDE received treatment for depression compared with 40.2% for Whites.

Suicide Deaths

Suicide deaths per 100,000 population, by race, 2008-2013, and stratified by sex for Blacks and Whites, 2013

Charts show suicide deaths per 100,000 population. Text descriptions are below the image.

Left Chart:

Race 2008 2009 2010 2011 2012 2013
Total 14.0 14.2 14.6 14.9 15.2 15.2
White 15.7 15.9 16.4 16.8 17.1 17.2
Black 6.3 6.2 6.2 6.4 6.7 6.5
API 6.7 7.1 7.6 7.2 7.6 7.1
AI/AN 12.2 12.1 13.1 12.8 13.1 14.1

Right Chart:

Race Males Females
White 27.3 7.6
Black 11.2 2.4

2008 Achievable Benchmark: 9 per 100,000 Population.

Key: API = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System—Mortality, 2008-2013.
Note: For this measure, lower rates are better. Estimates are age adjusted to the 2000 U.S. standard population.

  • Importance: According to the Centers for Disease Control and Prevention (Xu, et al., 2014), the rate for the top 10 leading causes of death has decreased or held steady, except the 10th leading cause of death in the United States, suicide. Rates of attempted suicide vary considerably among demographic groups. The economic cost of suicide death in the United States was estimated in 2010 to be more than $44 billion annually.
  • Overall Rate: In 2013, the overall suicide death rate was 15.2 per 100,000 population age 12 and over.
  • Trends: From 2008 to 2013, suicide death rates worsened for the total population, Whites, Asians and Pacific Islanders (APIs), and American Indians and Alaska Natives (AI/ANs), but not for Blacks.
  • Groups With Disparities:
    • From 2008 to 2013, Blacks, APIs, and AI/ANs had lower suicide death rates than Whites.
    • In 2013, males had higher suicide death rates compared with females. White females had a higher rate than Black females and White males had a higher rate than Black males.
  • Achievable Benchmark:
    • The 2008 top 5 State achievable benchmark was 9 suicide deaths per 100,000 population. The top 5 States that contributed to the achievable benchmark are Connecticut, District of Columbia, Massachusetts, New Jersey, and New York.
    • APIs and Blacks have achieved the benchmark.
    • The total population, AI/ANs, and Whites are moving away from the benchmark.

Return to Contents

Page last reviewed June 2018
Page originally created March 2016

Internet Citation: Part 2: Trends in Priorities of the Heckler Report—Suicide Prevention and Mental Health Care. Content last reviewed June 2018. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/research/findings/nhqrdr/chartbooks/blackhealth/part2-spmh.html

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