Ethnic Differences in Mental Disorders and Service Use among Children and Adolescents: Evidence from the 2001-2004 National Health and Nutrition Examination Survey

Objectives: Using a nationally representative sample of children and adolescents, this paper examines ethnic differences in 12-month: (a) prevalence rates of DSM-IV mood, anxiety and behavior disorders; and (b) service utilization rates, among those with a DSM-IV diagnosis of mood disorders and ADHD.

Methods: Data for analysis come from a probability sample of 3,042 children and adolescents aged 8-15 years participating in the 2001-2004 National Health and Nutrition Examination Surveys (NHANES). DSM-IV criteria for mental disorders were derived from administration of selected modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children, Version IV (DISC). Five ethnic groups were compared: (1) White, non-Hispanic, (2) Black, non-Hispanic, (3) Mexican-American, (4) Other, Hispanic, (5) Other non-Hispanic.

Results: There were no differences in the prevalence of mood or anxiety disorders or conduct disorder between ethnic subgroups. However, Hispanic youth, particularly those with parents born in Mexico, had lower one-year prevalence rates, and lower rates of mental health service use among those with ADHD(OR=0.38 [95% CI = 0.18-0.82]. compared to non-Hispanic Whites.

Conclusions: The lack of ethnic differences in the prevalence and service patterns for most conditions found in this study while reassuring may not extend to the full range of mental disorders in youth that were not included in this study. The lower mental health service rates among the offspring of Mexican immigrants suggests the importance of future studies designed to examine cultural factors in the recognition and intervention among children with ADHD.