SMART RICHMAN ET AL.DISCRIM NATIO, IDENTITY, UTILIZATION THE ROLE OF DISCRIMINATION AND RACIAL IDENTITY FOR MENTAL HEALTH SERVICE

Several reports have documented different patterns in mental health service utiliza-tion among ethnic minority groups, particularly for Black Americans, in compari-son to Whites. In this research, we examined individual variables that may underlie these differences, focusing on experiences of discrimination and racial identity. We used a community sample of over 1,000 White and Black American adults re-siding in a large Midwestern metropolitan area. Results showed that discrimination or unfair treatment was marginally associated with increased utilization for Black Americans after controlling for age, gender and psychological distress, but prior to taking SES and identity into account. For Black Americans, those with high racial identity who experienced discrimination reported a lower probability of utilization in comparison to those with low racial identity. For White Americans, only gender and psychological distress were associated with utilization. Results are discussed in terms of the functions that racial identity may play for Black Americans in the context of health seeking behaviors. Even though all ethnic and racial groups underutilize mental health ser-vices, ethnic minority groups have the greatest disparity between need and use (e.g., USDHHS, 2001; Neighbors et al., 1992; Snowden, 2001). At least one community study has reported a decrease in disparities over time (Cooper–Patrick et al., 1999), but other national data support the conclusion that national disparities in utilization persist (Wells et al.