Carson and colleagues compare how Haitian, African American and non-Latino White young people used outpatient mental health care, drawing on five community clinics in a northeastern U.S. city. The method was a retrospective review of 252 charts, counting sessions and treatment types over the first six months of care and testing whether treatment met published guidelines for ADHD and depression once clinical need was accounted for.

Retention was low among both Haitian and African American patients. Most had stopped by six months, most attended fewer than eight sessions, and a third came only once. Among Haitian patients, milder symptoms and less dysfunction predicted a single visit. Guideline-adherent treatment was less likely for Haitians, and adequate depression care was more common among the older patients in the sample.

Haitian youth were also relatively underinsured, had more documented family separations, and were given adjustment disorder diagnoses at higher rates. Coverage, the authors suggest, is a likely driver.