Mental Health Weekly Digest, June 9th, 2003- Minorities living in relatively wealthy New York City neighborhoods are more likely to receive mental health care in emergency rooms and hospitals than white people living in the same areas, a new study concludes. The trend may suggest that minorities in these neighborhoods are receiving sporadic "crisis"care rather than regular mental health care. Blacks and Hispanics who live in low-poverty areas are also more likely to be referred to public mental health services by police or social services personnel rather than family or friends, as is the case for white residents.
"Minorities in low-poverty areas may stand out as more "attention-worthy" than others - more visible- such that their deviant behaviors are readily recognized and constrained," suggested Julian Chun-Chung Chow, PhD, of the University of California, Berkeley, and colleagues. The research, published in the American Journal of Public Health, is one of the first studies conducted outside of California that compares mental health services use by minorities living at different poverty levels, the researchers say. Chow and colleagues compared public mental health services use among 33,278 white, 23,683 black, 19,849 Hispanic and 1275 Asian patients in low- and high-poverty areas in New York. In their study, low-poverty areas were defined as zip code regions where fewer than 20% of households were below the poverty level. High-poverty areas were those in which 20% or more of the households were living above the poverty level.
Minority mental health service users were more likely than white users to live in high-poverty areas. Twenty-seven percent of Asian patients, 49% of black patients and 61% of Hispanic patients lived in these poorer neighborhoods, compared with 15% of their white counterparts. Compared to the overall population in low-poverty neighborhoods, a disproportionately high number of black and Hispanic residents in low-poverty areas used public mental health services, the researchers found. The number of white and Asian patients using the public services in low-poverty areas was lower than expected. Chow and colleagues' findings also suggested that youth are important users of public mental health services. They noted that 25% of black and Hispanic public services patients, along 10% of white and Asian patients, were 18 years old or younger. These percentages were the same in both low- and high-poverty neighborhoods (Chow JC, Jaffee K, Snowden L, et al., Racial/ethnic disparities in the use of mental health services in poverty areas. Am J Public Health, 2003;93(5):792-7).