We aimed to evaluate attitudes and preferences on mental health (MH) and MH care (MHC) delivery in persons with multiple sclerosis (MS) across racial/ethnic groups.

Despite being at increased risk of psychiatric comorbidity, MH disorders in individuals living with MS, particularly racial/ethnic minorities, are underdiagnosed and undertreated.

We surveyed persons with self-reported MS on their attitudes about MH and MHC preferences. We also administered patient-reported measures including the Patient Health Questionnaire-9. MS organizations distributed survey invitations electronically. Analyses were conducted using comparison of proportions.

2246 persons (2100 Caucasian [CA], 143 African-American [AA]; 125 Hispanic [H]; age 51.2±12.3, 69.8% moderate-to-severe depression) completed the survey. Participants of all racial/ethnic groups reported that emotional problems are common with MS (83.4%) and could worsen MS symptoms (83.3%). A total of 26.6% have an MH provider (MHP) and 29.8% previously had one, the top reasons for stopping treatment included: “got better” (47.8%), “wanted to handle problems on own” (8.7%), “too expensive” (8.3%), “lack of time/transportation” (5.8%), and “bad experiences with treatment” (4.3%). 74.4% of respondents would attend MHC visits if co-located with their MS care, while higher proportions of H (88.6%) compared to non-Hispanics (NH) (73.8%) (p=<0.001) and AA (82.1%) compared to CA (73.8%) would attend if co-located (p=0.003). AA reported stronger preferences to be matched with an MHP of the same race/ethnicity (25.2% AA, 11.2% CA, p=<0.001), gender (37.8% AA, 28.3% CA, p=0.001), age group (26.1% AA, 20.8% CA, p=<0.001), and religion (21.8% AA, 14.0% CA, p=0.01). Compared to CA, AA would feel better understood (28.0% AA, 11.2% CA, p=<0.001) and would trust more (18.4% AA, 7.5% CA, p=<0.001) if their MHP shared their race/ethnicity.

MS affects a diverse population with varying attitudes/preferences on MH in MS and MHC delivery. Understanding these differences may facilitate the development of a patient-centered approach.