Ethnic differentials in mental health needs and service utilization among persons with cancer

Purpose: Improving the assessment of and access to appropriate care for mental health problems among persons with cancer is essential, particularly for population groups that are at high risk for psychopathology. This study characterized ethnic differentials regarding needs and service utilization by Jewish (n=1,430) and Arab-Israeli (n=141) persons with cancer. Methods: We reviewed 284 randomly selected active medical charts in an oncology clinic in a large public hospital (November 2010-April 2011). Results: While 12 % of the charts of the Jewish-Israeli sample included a record of psychiatric disorders or symptoms, only 5 % of the charts of the Arab-Israeli sample had a similar record (χ²=4.4, p<.05). Similarly, in a higher percentage of the charts of the Jewish-Israeli sample, the current utilization of psychotropics (18.2 and 5.6 %, respectively; χ²=6.7; p<.01) and/or psychotherapy (7.8 and 1.4 %, respectively; χ²=3.6; p<.05) was noted compared with the Arab-Israeli sample. Also, in a higher percentage of the charts of the Jewish-Israeli patients, a referral for psychotherapy was recorded compared with their Arab counterparts (9.1 and 4.3 % respectively; χ²=6.3; p<.05). In contrast, 19.1 % of the Arab-Israelis were recommended with welfare assistance compared to their Jewish-Israeli counterparts, 10.5 % (χ²=5.35; p<.05). Conclusions: Despite methodological limitations, findings confirm past research showing that disadvantaged ethnic minorities may receive differential recommendations for mental health problems among persons with cancer. This may contribute to the differential treatment gap in mental health care among persons with cancer of contrasting ethnic groups.