Abstract PS4-12-15: Racial and Ethnic Disparities in Mental Health Care Among Breast Cancer Survivors with Serious Psychological Distress

Abstract Background: Breast cancer survivors with serious psychological distress (SPD) often require mental health support, yet access and utilization may differ by race/ethnicity. This study examined disparities in mental health service use and psychotropic medication utilization across racial and ethnic groups. Methods: We conducted a cross-sectional analysis using pooled 2018-2022 data from the Medical Expenditure Panel Survey. Adult female breast cancer survivors with SPD were identified and grouped as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, and Non-Hispanic Other (NHO). We present sociodemographic characteristics (Table 1) and adjusted comparisons of counseling visits, provider visits, mental health costs, and psychotropic medication use (Table 2). Multivariable models adjusted for education, marital status, poverty level, and insurance type. Results: Compared to NHW patients, NHB patients had significantly fewer counseling visits (OR: -1.64, 95% CI: -2.59 to -0.72) and lower antidepressant (-14.6%, 95% CI: -24.9 to -5.7) and anxiolytic use (-12.8%, 95% CI: -19.6 to -4.7). Hispanic patients also had reduced antidepressant use (-9.9%, 95% CI: -18.9 to -0.6), and NHO patients had fewer psychiatrist visits (-1.19, 95% CI: -1.92 to -0.53) and lower anxiolytic use (-15.1%, 95% CI: -24.9 to -4.8). No significant differences in mental health visit costs or out-of-pocket spending were found across groups. Conclusion: Despite similar cost burdens, NHB and Hispanic breast cancer survivors with SPD are less likely to receive counseling and psychotropic medications than NHW peers. Targeted interventions are needed to reduce racial disparities in mental health care among cancer survivors. Citation Format: A. Allibhai, A. Allibhai. Racial and Ethnic Disparities in Mental Health Care Among Breast Cancer Survivors with Serious Psychological Distress [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-12-15.