Patients are increasingly likely to open up to their primary care physicians about mental health concerns. However, Black and Latino patients are less likely to have these concerns addressed compared with white people, according to a new study published in Health Affairs.

Researchers from Brigham and Women’s Hospital looked at national data on primary care visits from 2006 and 2007 and compared them with data from 2016 and 2018. They found a 50% increase in care visits addressing mental health concerns. They also found that Black and Latino patients were 40% less likely to have mental health concerns addressed compared with non-Latino and white patients.

In a Brigham and Women’s news release, the study’s corresponding author, primary care physician Lisa Rotenstein, MD, MBA, said: “The scope of primary care has widened and primary care physicians are more likely to be delivering whole-person care, and that includes addressing mental health concerns…. Primary care physicians welcome the opportunity to help their patients address mental health concerns but often need better systems of support to provide the care patients want and need beyond their primary care visit.”

In the United States, about one in five adults reported having a mental, emotional or behavioral disorder, according to 2020 data from the National Institutes of Mental Health. Rotenstein and her team analyzed a sample of 109,898 primary care visits and found a significant increase in care visits that addressed mental health concerns. In 2006 and 2007, 10.7% of primary care visits addressed a mental health concern. This figure rose to 15.9% by 2016 and 2018.

Researchers found significant differences in the likelihood that a patient would have their mental health concerns addressed according to their race, insurance type, sex and age. Researchers also found that meeting with one’s usual primary care physician increased the likelihood of addressing mental health concerns compared with meeting with another clinician.

“While our data do not tell us why we see differences in the proportion of visits addressing mental health concerns when we look at rates by race and ethnicity, the findings tell us that we need to be looking into the barriers—including process disparities and structural and communication barriers—that may prevent all patients from accessing care as needed,” Rotenstein said.

Rotenstein added: “We know that mental health concerns are best addressed with a team approach. Primary care can be an entry point for patients but we need to consider strategies, such as co-locating primary care providers and psychiatry providers and offering longer visits, that will enable primary care physicians to adequately address mental health needs.”

Because the latest data available data were from 2018, before the emergence of COVID-19 and the greater adoption of telehealth, the researchers noted that the proportion of primary care visits addressing mental health may have changed.