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Articles   |    
Progress in Improving Mental Health Services for Racial-Ethnic Minority Groups: A Ten-Year Perspective
Catherine DeCarlo Santiago, Ph.D.; Jeanne Miranda, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200517
View Author and Article Information

Dr. Santiago is with the Department of Psychology, Loyola University Chicago (e-mail: csantiago4@luc.edu). Dr. Miranda is with the Department of Psychiatry and the Center for Health Services and Society, University of California, Los Angeles.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  This study examined progress in making the mental health workforce more diverse and in better representing racial-ethnic minority groups in randomized intervention trials of common mental disorders since the publication of the U.S. Surgeon General’s 2001 report Mental Health: Culture, Race, and Ethnicity.

Methods  Data on the mental health workforce were drawn from a work group comprising research staff from the American Psychiatric Association, American Psychological Association, and the National Association of Social Workers; representatives of professional psychiatric nursing; and staff from the National Institute of Mental Health. Additional data were pooled from clinical trials published between 2001 and 2010, which were examined for inclusion of racial-ethnic minority populations. Proquest, PubMed, and Google Scholar were searched for the terms “clinical trials” and “randomized trials.” The search was constrained to trials of adults with bipolar disorder, schizophrenia, and major depression, along with trials of children and adults with attention-deficit hyperactivity disorder.

Results  Between 1999 and 2006, professionals from racial-ethnic minority groups increased from 17.6% to 21.4% in psychiatry, from 8.2% to 12.9% in social work, and from 6.6% to 7.8% in psychology. Reporting race-ethnicity in clinical trials has improved from 54% in 2001 to 89% in 75 studies of similar disorders published by 2010, although few ethnic-specific analyses are being conducted.

Conclusions  Little progress has been made in developing a more diverse workforce; racial-ethnic minority groups remain highly underrepresented. There is more representation of racial-ethnic minority populations in randomized intervention trials, but their numbers often remain too small to analyze. Recommendations for improving both areas are considered.

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Table 1Proportion of clinically trained mental health professionals from racial-ethnic minority groups compared with U.S. population, in percentages
Table Footer Note

a The 1999 American Psychiatric Association membership residing in the United States, excluding medical students, psychiatry residents, corresponding psychiatrists, and inactive members. Race-ethnicity was not specified for 6.2%.

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b The 2006 American Psychiatric Association membership residing in the United States, excluding medical students, psychiatric residents, international members and fellows, inactive members, associates, fellows, and honorary fellows. One race-ethnicity was not specified for 7.9% (data were missing or respondents reported multiethnicity).

Table Footer Note

c American Psychological Association data. Race-ethnicity was not specified for 5.5%.

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d American Psychological Association Member Directory 2006. Compiled by APA Center for Workforces Studies. One race-ethnicity was not specified for 20.5% (data were missing or respondents reported multiethnicity).

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e Association for Social Work Board estimates. Race-ethnicity not specified for .8%

Table Footer Note

f The Association for Social Work Board estimates the number of licensed social workers to be 310,000. This number excludes bachelor level, doctorate level, and nondegreed licensed social workers. An estimated 79% of this number, or 244,900, have M.S.W. degrees and are thus eligible to hold clinical licenses. The proportion with an M.S.W. degree and a clinical license is unknown. Hence, for purposes of this table, the total number of clinically trained social workers was considered to be 244,900.

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Table 2Analyses of specific racial-ethnic groups reported in clinical trials from the 2001 Surgeon General’s report
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Table 3Analyses of specific racial-ethnic groups reported in 75 clinical trials, 2001–2010
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References

 Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General .  Rockville, Md, US Department of Health and Human Services, US Public Health Service, 2001
 
 Mental Health: A Report of the Surgeon General .  Rockville, Md, US Department of Health and Human Services, US Public Health Service, 1999
 
Rogers  MR;  Molina  LE:  Exemplary efforts in psychology to recruit and retain graduate students of color.  American Psychologist 61:143–156, 2006
[CrossRef] | [PubMed]
 
Vasquez  MJ;  Jones  JM:  Increasing the number of psychologists of color: public policy issues for affirmative diversity.  American Psychologist 61:132–142, 2006
[CrossRef] | [PubMed]
 
Rochon  PA;  Mashari  A;  Cohen  A  et al:  The inclusion of minority groups in clinical trials: problems of under representation and under reporting of data.  Accountability in Research 11:215–223, 2004
[CrossRef] | [PubMed]
 
Geller  SE;  Adams  MG;  Carnes  M:  Adherence to federal guidelines for reporting of sex and race/ethnicity in clinical trials.  Journal of Women’s Health 15:1123–1131, 2006
[CrossRef]
 
Berger  JS;  Melloni  C;  Wang  TY  et al:  Reporting and representation of race/ethnicity in published randomized trials.  American Heart Journal 158:742–747, 2009
[CrossRef] | [PubMed]
 
Braslow  JT;  Duan  N;  Starks  SL  et al:  Generalizability of studies on mental health treatment and outcomes, 1981 to 1996.  Psychiatric Services 56:1261–1268, 2005
[CrossRef] | [PubMed]
 
Mak  WW;  Law  RW;  Alvidrez  J  et al:  Gender and ethnic diversity in NIMH-funded clinical trials: review of a decade of published research.  Administration and Policy in Mental Health and Mental Health Services Research 34:497–503, 2007
[CrossRef] | [PubMed]
 
NIH Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research. Federal Register 59(221):doc 94-28323. Rockville, Md, National Institutes of Health, 1994
 
Manderscheid RW, Henderson MJ: Status of National Accountability Efforts at the Millennium. DHHS/PHS pub no SMA-01-3537. Rockville, Md, Substance Abuse and Mental Health Services Administration, 2000
 
Manderscheid RW, Henderson MJ: Mental Health, United States 2010. DHHS/PHS pub no SMA-12-4681. Rockville, Md, Substance Abuse and Mental Health Services Administration, 2010
 
American Psychiatric Association:  Practice guideline for the treatment of patients with bipolar disorder.  American Journal of Psychiatry 151(Dec suppl):1–36, 1994
 
American Psychiatric Association:  Practice guideline for the treatment of patients with schizophrenia.  American Journal of Psychiatry 154(suppl):1–63, 1997
 
American Psychiatric Association:  Practice guideline for the treatment of patients with major depression.  American Journal of Psychiatry 157(April suppl):1–45, 2000
 
Jadad  AR;  Boyle  M;  Cunningham  C  et al:  The Treatment of Attention-Deficit/Hyperactivity Disorder: An Evidence Report .  Rockville, Md,  US Department of Health and Human Services, Agency for Healthcare Research and Quality, 1999
 
Clay  R;  A:  Repairing psychology’s leaky pipeline.  Monitor on Psychology 40(10):56, 2009
 
Hall  GCN:  Diversity in clinical psychology.  Clinical Psychology: Science and Practice 13:259–262, 2006
[CrossRef]
 
Szapocznik  J;  Santisteban  D;  Kurtines  W  et al:  Bicultural effectiveness training: a treatment intervention for enhancing intercultural adjustment in Cuban American families.  Hispanic Journal of Behavioral Sciences 6:317–344, 1984
[CrossRef]
 
Carney  RM;  Freedland  KE;  Rubin  EH  et al:  Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: a randomized controlled trial.  JAMA 302:1651–1657, 2009
[CrossRef] | [PubMed]
 
Goldstein  DJ;  Lu  Y;  Detke  MJ  et al:  Effects of duloxetine on painful physical symptoms associated with depression.  Psychosomatics 45:17–28, 2004
[CrossRef] | [PubMed]
 
Miranda  J;  Chung  JY;  Green  BL  et al:  Treating depression in predominantly low-income young minority women: a randomized controlled trial.  JAMA 290:57–65, 2003
[CrossRef] | [PubMed]
 
Arnold  LE;  Elliot  M;  Sachs  L  et al:  Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD.  Journal of Consulting and Clinical Psychology 71:713–727, 2003
[CrossRef] | [PubMed]
 
Huey  SJ  Jr;  Polo  AJ:  Evidence-based psychosocial treatments for ethnic minority youth.  Journal of Clinical Child and Adolescent Psychology 37:262–301, 2008
[CrossRef] | [PubMed]
 
Miranda  J;  Bernal  G;  Lau  A  et al:  State of the science on psychosocial interventions for ethnic minorities.  Clinical Psychologist 1:113–142, 2005
[CrossRef]
 
Lieberman  AF;  Weston  DR;  Pawl  JH:  Preventive intervention and outcome with anxiously attached dyads.  Child Development 62:199–209, 1991
[CrossRef] | [PubMed]
 
Miranda  J;  Siddique  J;  Der-Martirosian  C  et al:  Depression among Latina immigrant mothers separated from their children.  Psychiatric Services 56:717–720, 2005
[CrossRef] | [PubMed]
 
Miranda  J;  Schoenbaum  M;  Sherbourne  C  et al:  Effects of primary care depression treatment on minority patients’ clinical status and employment.  Archives of General Psychiatry 61:827–834, 2004
[CrossRef] | [PubMed]
 
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