Ethnic differences in utilization of youth mental health care

There is an overall underutilization of youth mental health care (YMHC). It is unknown whether underutilization differs per ethnic group. Therefore, this study is aimed at gaining insight into the effects of ethnicity, age and gender on this utilization.

The sample consisted of outpatient children (age 5-10) (n=1940) and adolescents (age 11-19) (n=2484) admitted to a Dutch YMHC centre. Ethnic background of the patients (patient registration system) was compared to that of the general population (municipality files). Relative risks (RRs) on utilization for non-native groups were calculated with natives as the reference group.

With regard to children, female children from Moroccan, Turkish and other non-native western descent were less likely to enter mental health care than native Dutch female children. The RR was 0.24 for Moroccan girls, 0.53 for Turkish girls, and 0.60 for girls from other non-native western countries. Male children from almost all non-native groups were also less likely to enter mental health care than native Dutch male children, with the RRs being between 0.43 and 0.65. With regard to adolescents, most non-native adolescents, were as likely as native adolescents to enter mental health care. An exception were males and females from Morocco and males from Turkey and non-native western countries, who were less likely than Dutch adolescents to enter mental health care (RRs between 0.61 and 0.80).

Results imply that YMHC is less accessible for children from a minority background than for children from a native background. With adolescents, there is no difference in accessibility between natives and non-natives. Future research should focus on the reasons for this difference in accessibility. Potential mediators such as socioeconomic status, discrimination, acculturation processes, language barriers should be taken into account.