(PS11-44) Exploring Differences in Insurance Coverage and Treatment Among Race and Ethnic Minorities That Self-injure

Self-injury has been an ongoing significant public health concern for many years. While extensive research has been conducted on the etiology and treatment of self-injury, disparities in its prevalence, insurance coverage, and treatment outcomes among different racial and ethnic groups persist. This study examines the relationship between race and ethnicity, and insurance coverage and treatment accessibility among minority groups that engage in nonsuicidal self-injury (NSSI).

The Minority Stress Model suggests that individuals from marginalized groups experience high rates of stress due to stigmatization, discrimination, and social inequalities, which significantly impact their mental health and well-being. Research suggests that individuals from racial and ethnic minority backgrounds, including but not limited to Black and Hispanic communities, often encounter systemic barriers to accessing quality mental health care and treatment services (Chesin et al., 2013, Rojas-Velasquez et al., 2021). These barriers may include limited insurance coverage, cultural stigma surrounding mental health issues, and inadequate representation of minority therapists and counselors. Applying this model to the context of NSSI, racial and ethnic minorities may engage in NSSI as a way to cope with the cumulative effects of minority stress.

In this study, we explore differences in NSSI frequency, insurance coverage, and current and historic mental health treatment. We hypothesize that individuals from racial and ethnic minority backgrounds will report greater NSSI frequency and be less likely to report insurance coverage and treatment. 

We ran descriptives on a sample of 6,643 individuals with the median age of 17.89 who voluntarily took a mental health screener on a large national advocacy group’s website, and reported a lifetime history of NSSI. Among those, 3,741 were White, 443 were Black, 849 were Hispanic/Latin, 296 were Asisan, and 967 identified as Other (American Indian, or Alaska Native Native Hawaiian or other Pacific Islander Middle Eastern or North African). We ran 3 chi-square tests to explore insurance coverage and treatment across race and ethnicity groups. We found that all but white populations were less likely to report lifetime treatment (X-squared = 198.86, df = 8, p < .001), current treatment (X-squared = 221.23, df = 8, p < .001), and insurance (X-squared = 85.8, df = 8, p < .001). 
We ran an ANOVA analysis exploring past month NSSI frequency by race and ethnicity. This was significant (F(4, 6291) = [9.96], p < 0.001), showing that individuals in the Other race category reported the highest NSSI frequency relative to all other groups. We will explore this relationship and our interpretation further in our ABCT poster.