Service utilization differences for axis I psychiatric and substance use disorders between white and black adults

Katherine M. Keyes, Mark L. Hatzenbuehler, Philip Alberti, William E. Narrow, Bridget F. Grant, Deborah S. Hasin

Research output: Contribution to journalArticlepeer-review

65 Scopus citations


Objective: Although studies have shown disparities between black and white populations in service utilization for mental disorders, little information exists on whether such disparities apply equally across disorders. The objective of this study was to examine racial differences in lifetime prevalence of service utilization for mood and anxiety disorders and for alcohol and drug use disorders, with controls for predisposing, enabling, and need-for-service variables unequally distributed between racial-ethnic groups. Methods: Data were from a face-to-face epidemiologic survey of 32,752 non-Hispanic white or black adults ages 18 and older residing in households and group quarters in the United States. Main outcome measures were treatment for mood, anxiety, and alcohol and drug use disorders. Results: White adults were consistently more likely than black adults to have had treatment for mood disorders (odds ratio [OR]=2.16, 95% confidence interval [CI] = 1.80-2.59) and anxiety disorders (OR=1.77, 95% CI=1.43-2.19) after adjustment for predisposing and enabling factors and need for service (severity of disorder). In contrast no evidence of lower service utilization for treatment of alcohol use disorders emerged among black respondents (OR=.87, 95% CI=.69-1.10). Moreover, white respondents with drug use disorders were significantly less likely than black respondents to receive treatment for a drug problem (OR=.64, 95% CI=.47-.88). Conclusions: Differences in treatment between black and white adults depended on the specific disorder and type of treatment considered. Prevention and intervention strategies should address disorder-specific disparities in services received.

Original languageEnglish (US)
Pages (from-to)893-901
Number of pages9
JournalPsychiatric Services
Issue number8
StatePublished - Aug 2008
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'Service utilization differences for axis I psychiatric and substance use disorders between white and black adults'. Together they form a unique fingerprint.

Cite this