Objective: There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However,
previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external
validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient
treatment for depression in the Netherlands.
Methods: Longitudinal data (2001-2005) were extracted from a nationwide
psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available
about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health
care. Data were analyzed with linear, logistic, and Cox regression analyses.
Results: When analyses were controlled
for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan,
Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority
and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for
Surinamese and Antillean clients compared with ethnic Dutch.
Conclusions: The data provided insufficient support
for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding
may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also
indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the
influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and
Moroccan clients, should not be disregarded. (Psychiatric Services 61:690-697, 2010)