Self-rated mental health and racial/ethnic disparities in mental health service use

Med Care. 2008 Sep;46(9):915-23. doi: 10.1097/MLR.0b013e31817919e5.


Background: Studies of health service use for emotional problems show that the majority of those with disorders do not seek professional help. In addition, mental health service use is lower among members of minority communities, compared with non-Hispanic whites.

Objective: To examine the role of self-reported mental health as an indicator of awareness of mental conditions and as an influence in the process of seeking mental health care.

Research design: We conducted cross-sectional analyses of nationally representative data from the Medical Expenditure Panel Survey (MEPS) for 2000-2004.

Measures: In-person interviews obtained data on self-rated mental health (SRMH), ambulatory mental health visits, and purchase of prescription medications to treat mental conditions. Respondents completed the SF-12 health status survey; analyses included the SF-12 mental component summary (MCS) as a measure of emotional symptoms. Analyses included only those who provided self-reports of MCS and SRMH.

Results: SRMH was related to any ambulatory visit and any medication purchase for mental health treatment, controlling for MCS, and other sociodemographic and clinical variables. The association between SRMH and service use was weaker for black and Hispanic respondents than for whites. In addition, the magnitude of the association between SRMH and MCS was weaker for black and Hispanic respondents than for whites.

Conclusions: Racial/ethnic differences in service use may arise in part from different propensities to interpret emotional symptoms as reflecting one's mental health and then to seek professional intervention for emotional problems. SRMH may be useful as an indicator of the extent to which people acknowledge the existence of emotional problems.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Affective Symptoms / epidemiology
  • Affective Symptoms / ethnology*
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / statistics & numerical data
  • Attitude to Health*
  • Black People / psychology*
  • Black People / statistics & numerical data
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Health Expenditures / statistics & numerical data
  • Health Services Research
  • Health Status
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / psychology*
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data*
  • Mental Health*
  • Middle Aged
  • Psychotherapy / statistics & numerical data
  • Psychotropic Drugs / therapeutic use
  • Surveys and Questionnaires
  • United States
  • Utilization Review / statistics & numerical data
  • White People / psychology*
  • White People / statistics & numerical data


  • Psychotropic Drugs