Racial Disparities In Mental Illness Among U.S. Fathers

Background and Purpose: Fatherhood is a central component of many men's lives. Not only do fathers impact the well being their children, fatherhood status is also expected to impact men's physical and psychiatric health (Garfield et al, 2006). However, lacking is a comprehensive profile of the psychiatric health of US fathers, particularly one that takes into consideration how variations in the social contexts of fatherhood (e.g., marital, socio-economic, and residential status) impact the psychiatric health of men nationally. Developing such a comprehensive profile will allow physicians and clinicians to consider issues relevant to fatherhood in their decision making process (Garfield et al. 2006). This study presents for the first time nationally representative data on the prevalence and correlates of psychiatric disorders among African American, Latino, Asian, and White fathers in the United States.

Method: National estimates of the lifetime and 12-month prevalence rates of psychiatric disorders, correlates of psychiatric disorders, age of onset, and mental health services and prescribed medication patterns are reported on Black , Latino, Asian, and White fathers using data from the National Institute of Mental Health Collaborative Psychiatric Epidemiology Surveys (National Survey of American Life [NSAL], National Latino Asian American Survey [NLAAS], and National Comorbidity Survey-Replication [NCS-R]). Data are Psychiatric diagnoses were assessed using a fully structured diagnostic interview (DSM-IV/WMH-CIDI). Descriptive and logistic regression analyses were performed. The data were weighted to adjust for the stratified multistage sample design, clustering of the data and for differential non-response. Multivariate tests are based on Rao-Scott ÷2's computed from coefficient variance-covariance matrices that were adjusted for design effects.

Results: The lifetime prevalence rate for psychiatric disorder was 35.6%, 32.1%, 13.6%, and 28.8% for White, Black, Asian, and Latino fathers respectively (p<.001). Among US fathers, blacks reported the highest (14%, p<.05) 12-month prevalence rate for having at least one of 13 measured lifetime psychiatric disorders. In contrast to the other racial groups, the prevalence in the lifetime and 12-month rate of psychiatric disorder is higher for black fathers than it was for black males (non-fathers). Among black males, the odd for a 12-month disorders increased by 50 percent (AOR=1.5; 95%CI= 1.00 -2.36; p<.05) relatives to whites. Factors associated with a reduced risk of psychiatric illness for US fathers included being over 60 years of age and foreign-born. Fathers who were not in the labor force or widowed were almost twice as likely to have psychiatric illness. We found no racial difference in the use of mental health services among fathers.

Conclusions and Implications: The prevalence of psychiatric morbidity among US fathers varies by race, with black father minorities being of higher risk, particularly if they are single and unemployed. For blacks, fatherhood status was significantly associated with a higher risk for poor psychiatric health. The findings suggest that the causes and consequences of psychiatric disorders among fathers should be the focus of research attention and social workers should inquire about the mental health of these men.