Racial-Ethnic Disparities in Outpatient Mental Health Care in the United States

Psychiatr Serv. 2023 Jul 1;74(7):674-683. doi: 10.1176/appi.ps.20220365. Epub 2023 Jan 4.


Objective: The authors aimed to compare national rates and patterns of use of outpatient mental health care among Hispanic, non-Hispanic Black, and non-Hispanic White individuals.

Methods: Data from the 2018-2019 Medical Expenditure Panel Survey, a nationally representative survey of U.S. households, were analyzed, focusing on use of any outpatient mental health care service by non-Hispanic White (N=29,126), non-Hispanic Black (N=7,965), and Hispanic (N=12,640) individuals ages ≥4 years (N=49,731). Among individuals using any mental health care, analyses focused on those using psychotropic medications, psychotherapy, or both and on receipt of minimally adequate mental health care.

Results: The annual rate per 100 persons of any outpatient mental health service use was more than twice as high for White (25.3) individuals as for Black (12.2) or Hispanic (11.4) individuals. Among those receiving outpatient mental health care, Black (69.9%) and Hispanic (68.4%) patients were significantly less likely than White (83.4%) patients to receive psychotropic medications, but Black (47.7%) and Hispanic (42.6%) patients were significantly more likely than White (33.3%) patients to receive psychotherapy. Among those treated for depression, anxiety, attention-deficit hyperactivity disorder, or disruptive behavior disorders, no significant differences were found in the proportions of White, Black, or Hispanic patients who received minimally adequate treatment.

Conclusions: Large racial-ethnic gaps in any mental health service use and smaller differences in patterns of treatment suggest that achieving racial-ethnic equity in outpatient mental health care delivery will require dedicated efforts to promote greater mental health service access for Black and Hispanic persons in need.

Keywords: Epidemiology; Ethnicity; Health care disparities; Outpatient mental health care; Racial groups; Service 1delivery.

Publication types

  • Comparative Study

MeSH terms

  • Black or African American
  • Ethnicity
  • Healthcare Disparities* / ethnology
  • Healthcare Disparities* / statistics & numerical data
  • Hispanic or Latino
  • Humans
  • Mental Health Services
  • Mental Health*
  • Outpatients
  • Psychotropic Drugs / therapeutic use
  • Racial Groups
  • United States
  • White


  • Psychotropic Drugs