Literature review: Disparities in depression care for racial and ethnic minoritized youth

Objective: The aims of this paper are to review the current literature on racial and ethnic disparities in depression care for children and adolescents and identify strategies to provide culturally responsive care that eliminates disparities in depression care for youth. Our tertiary aim is to highlight gaps in the current literature. Methods: A systematic search of studies from January 1990 to July 2024 utilized the following databases: APA PsycInfo, EBM Reviews-Cochrane Register of Controlled Trials, EMB-Reviews, Cochrane Database of Systematic Reviews, and OVID Medline. Inclusion criteria encompassed various categories: ethnic and racial disparities in populations and clinical care, culturally informed interventions, and barriers to addressing access to care. Exclusion criteria include: articles not focused on depression care, articles without measurements of depressive symptoms, and partially completed studies. Results: 1403 abstracts were screened, with 24 articles meeting inclusion criteria. Barriers identified for youth include perceived stigma, historical barriers, and access to care. Among African Americans, Latinx, and Asian Americans sociocultural factors contribute to barriers for depression care and treatment utilization. Interventions identified included community-based programs and parental education with a culturally informed approach. Conclusion: The majority of the included studies were cross sectional studies which limits causal inference. Family and community-based interventions along with parental education were most effective in overcoming racial and ethnic disparities. There is an ongoing need to shift future studies to address the knowledge gaps around depression care for youth including improved strategies for early identification of depression, and effectiveness of interventions in diverse populations of youth.