Ethnic disparities in mental health treatment gap in a community-based survey and in access to care in psychiatric clinics

Ora Nakash, Maayan Nagar, Eli Danilovich, Daphne Bentov-Gofrit, Ido Lurie, Evelyne Steiner, Shiri Sadeh-Sharvit, Henri Szor, Itzhak Levav

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background: Contrasting social status of ethnic groups differentially impacts the use of psychiatric services, including in Israel, despite its universal health system. However, relevant studies are limited. Aims: To examine ethnic differences in mental health treatment gap and in access to specialized care. Methods: Data were gathered from two sources. Study I included Mizrahi (Jews of North African/Asian origin, socially disadvantaged, n = 136) and Ashkenazi (Jews of European American origin, socially advantaged, n = 69) who were diagnosed with common mental disorders in the preceding 12 months in the Israeli component of the World Mental Health Survey. Study II included Mizrahi (n = 133) and Ashkenazi (n = 96) service users entering ambulatory mental health care. Results: Study I showed that the treatment gap was larger among Mizrahi compared with Ashkenazi respondents (28% standard error (SE) = 4.1 and 45% SE = 6.2, respectively, sought services) following adjustment for sociodemographic confounders (adjusted odds ratio (AOR) = 2.28, 95% confidence interval (CI) = 1.1-4.8). Study II showed that the access to specialized care lagged over a year among 40% of service users of both ethnic groups. No significant ethnic differences emerged in variables related to delay in accessing care. Conclusions: Treatment gap was larger among ethnically disadvantaged compared with the advantaged group. However, once in treatment, service users of both ethnic groups report similar barriers to care.

Original languageEnglish
Pages (from-to)575-583
Number of pages9
JournalInternational Journal of Social Psychiatry
Volume60
Issue number6
DOIs
StatePublished - Sep 2014
Externally publishedYes

Bibliographical note

Funding Information:
Study I was supported by the Israeli Ministry of Health and Study II was supported by the Israel National Institute for Health Policy and Health Services Research (2006/6/א to Nakash).

Keywords

  • Treatment gap
  • ethnic differences
  • mental health
  • treatment barriers
  • treatment lag

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